To the Editor.
—Zavala and Binder are to be congratulated for their fine specular micrographs of epithelial ingrowth in the November Archives (1980;98:2007-2014). However, their analysis of ingrowth histopathologic characteristics seems equivocal and is thus confusing. Many experiments, including their own,1 have indicated that epithelium will not grow over normal endothelium because of contact inhibition. Yet the authors state: "Although the endothelial cells seemed slightly attenuated in thickness, their general overall ultrastructure seemed normal until they were approached by the leading edge of the ingrowth. The cell immediately adjacent to the ingrowth seemed normal." No attempt is made in the article to resolve this contradiction.There is convincing clinical evidence that epithelial ingrowth occurs only in areas of absent or previously damaged endothelium. The epithelium does not invade the anterior chamber after filtration surgery, because the endothelial margin remains normal. In nine cases, reported by the Wilmer Institute, Baltimore,
Sidrys LA. Epithelial Ingrowth. Arch Ophthalmol. 1981;99(4):697-698. doi:10.1001/archopht.1981.03930010697024