Histopathologica l findings intheiris ofdapsone treated leprosy patients

Nepalese leprosy patients skin smear negative, andtreated withdapsone (diamino diphenyl sulphone), andwithout anysignof active leprosy or iritis, specimens from iridectomy duringcataract surgery were studied histopathologically. Of49iris speci- mensonly six(12%) werefoundtobewithout anyhistopathological change. Atrophy ofthe iris stroma wasseenin63%andneovasculari- sation in6%ofall cases. In16%inwhichthe dilator musclecouldbedetected, itwas atrophic, andin11%thepigmented epithelium wasthinned andatrophic. Cellular inflamma- tory infiltrations wereseenin88%ofall speci- mens.Theyweremostly slight ineyeswhich before operation hadbeenwithout posterior synechiae oftheiris. Inmostoftheeyesin whichposterior synechiae hadbeenpresent moderate orheavy inflammatory cell infiltrates composed oflymphocytes andplasma cells, often associated withmacrophages, neutro- phils, oreosinophils, werefound. Infive iris specimens acid fast bacilli werepresent. This raises thequestion whether these cansurvive systemically despite dapsone chemotherapy in theiris, thusleading todapsone-resistant leprosy andtorecurrent iritis.