Descemet's membrane is usually intact, thickened or thinned. Histiocytes with a high degree of lysosomal activity are responsible for destruction of collagen fibrils. Histopathologic examination reveals an intact epithelium, loss of Bowman's membrane, and sometimes superficial stroma. Descemet's membrane is usually intact, thickened or thinned. Histiocytes with a high degree of lysosomal activity are responsible for destruction of collagen fibrils.
Treatment is based on both the visual symptoms and the biomicroscopic findings.
It consists initially of observation, treating the induced astigmatism as well as possible using spectacles, followed by a trial of rigid gas-permeable contact lenses when spectacles are unsatisfactory. Most patients can achieve adequate visual function with one of these options. In severe cases where the integrity of the eye is threatened, surgical intervention can be offered. Graefe's Arch Clin Exp Ophthalmol. Two- step annular tectonic lamellar keratoplasty in severe terrien's marginal degeneration.