Histopathology of Cornea and Iris in Chandler's Syndrome

Corneal and iris tissue were examined from a 72-year-old woman with Chandler's syndrome. Light and electron microscopy showed posterior, corneal, collagenous-layer production by metaplastic corneal endothelium. In areas of iridocorneal contact, there were several layers of metaplastic endothelial cells that covered iris stroma and melanocytes, which were directly subjacent to Descemet's membrane. Cells similar to the metaplastic endothelium covered the anterior surface of the iris specimen. Similar corneal endothelial metaplasia has been described in posterior polymorphous corneal dystrophy. Presumptive growth of corneal endothelium on the anterior iris surface has been observed in typical essential iris atrophy and in Cogan-Reese syndrome, both of which share several features with Chandler's syndrome. Proliferation of endothelium over the anterior chamber angle and the iris may play a role in glaucoma and in the iris abnormalities that occur in these disorders.