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Recurrence of macular corneal dystrophy on the graft 50 years after penetrating keratoplasty

Purpose: To report the recurrence of a macular corneal stromal dystrophy 50 years after penetrating keratoplasty (PKP). Methods: Observational case report Case description: A 76-year-old male patient presented with visual impairment in the right eye (OD) 50 years after PKP in 1962 (44 years after PK...

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Autores principales: Bischoff-Jung, Mona, Flockerzi, Elias, Hasenfus, Andrea, Viestenz, Arne, Matoula, Pinio, Schlötzer-Schrehardt, Ursula, Seitz, Berthold
Formato: Online Artículo Texto
Lenguaje:English
Publicado: German Medical Science GMS Publishing House 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452946/
https://www.ncbi.nlm.nih.gov/pubmed/32884888
http://dx.doi.org/10.3205/oc000161
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author Bischoff-Jung, Mona
Flockerzi, Elias
Hasenfus, Andrea
Viestenz, Arne
Matoula, Pinio
Schlötzer-Schrehardt, Ursula
Seitz, Berthold
author_facet Bischoff-Jung, Mona
Flockerzi, Elias
Hasenfus, Andrea
Viestenz, Arne
Matoula, Pinio
Schlötzer-Schrehardt, Ursula
Seitz, Berthold
author_sort Bischoff-Jung, Mona
collection PubMed
description Purpose: To report the recurrence of a macular corneal stromal dystrophy 50 years after penetrating keratoplasty (PKP). Methods: Observational case report Case description: A 76-year-old male patient presented with visual impairment in the right eye (OD) 50 years after PKP in 1962 (44 years after PKP also in the left eye (OS) in 1968) following explosion injury. His visual acuity had already been impaired before the trauma because of bilateral corneal opacities. The central corneal thickness of the graft measured 584 µm (OD) and 544 µm (OS), whilst the peripheral host thickness (8 mm zone), however, was 1233 µm (OD, cranial) and 1131 µm (OS, nasal). The original graft diameter measured 6 mm in both eyes and the recipient cornea was cloudy and gray. The endothelial cell count was measured centrally (OD 1162 c/mm(2), OS 1320 c/mm(2)). The visual acuity was 20/100 (OD) and 20/40 (OS). After excimerlaser-assisted repeated PKP (8.0/8.1 mm, OD), the histological analysis of the former graft revealed deposits of acid mucopolysaccharides (AMP) subepithelially, within the interface, in the donor stroma, and in the endothelium, which proved the peripheral recurrence of a macular corneal stromal dystrophy on the graft. Conclusion: Recurrence of macular corneal stromal dystrophy is seldom, but it may occur many decades after PKP. In this patient, the host’s stroma was twice as thick as that of the graft. This may be caused by the active production of acid mucopolysaccharides in the host endothelium with secondary endothelial decompensation. Thus, PKP remains the gold standard in the cure of macular corneal dystrophy for long-term visual rehabilitation.
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spelling pubmed-74529462020-09-02 Recurrence of macular corneal dystrophy on the graft 50 years after penetrating keratoplasty Bischoff-Jung, Mona Flockerzi, Elias Hasenfus, Andrea Viestenz, Arne Matoula, Pinio Schlötzer-Schrehardt, Ursula Seitz, Berthold GMS Ophthalmol Cases Article Purpose: To report the recurrence of a macular corneal stromal dystrophy 50 years after penetrating keratoplasty (PKP). Methods: Observational case report Case description: A 76-year-old male patient presented with visual impairment in the right eye (OD) 50 years after PKP in 1962 (44 years after PKP also in the left eye (OS) in 1968) following explosion injury. His visual acuity had already been impaired before the trauma because of bilateral corneal opacities. The central corneal thickness of the graft measured 584 µm (OD) and 544 µm (OS), whilst the peripheral host thickness (8 mm zone), however, was 1233 µm (OD, cranial) and 1131 µm (OS, nasal). The original graft diameter measured 6 mm in both eyes and the recipient cornea was cloudy and gray. The endothelial cell count was measured centrally (OD 1162 c/mm(2), OS 1320 c/mm(2)). The visual acuity was 20/100 (OD) and 20/40 (OS). After excimerlaser-assisted repeated PKP (8.0/8.1 mm, OD), the histological analysis of the former graft revealed deposits of acid mucopolysaccharides (AMP) subepithelially, within the interface, in the donor stroma, and in the endothelium, which proved the peripheral recurrence of a macular corneal stromal dystrophy on the graft. Conclusion: Recurrence of macular corneal stromal dystrophy is seldom, but it may occur many decades after PKP. In this patient, the host’s stroma was twice as thick as that of the graft. This may be caused by the active production of acid mucopolysaccharides in the host endothelium with secondary endothelial decompensation. Thus, PKP remains the gold standard in the cure of macular corneal dystrophy for long-term visual rehabilitation. German Medical Science GMS Publishing House 2020-08-06 /pmc/articles/PMC7452946/ /pubmed/32884888 http://dx.doi.org/10.3205/oc000161 Text en Copyright © 2020 Bischoff-Jung et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Bischoff-Jung, Mona
Flockerzi, Elias
Hasenfus, Andrea
Viestenz, Arne
Matoula, Pinio
Schlötzer-Schrehardt, Ursula
Seitz, Berthold
Recurrence of macular corneal dystrophy on the graft 50 years after penetrating keratoplasty
title Recurrence of macular corneal dystrophy on the graft 50 years after penetrating keratoplasty
title_full Recurrence of macular corneal dystrophy on the graft 50 years after penetrating keratoplasty
title_fullStr Recurrence of macular corneal dystrophy on the graft 50 years after penetrating keratoplasty
title_full_unstemmed Recurrence of macular corneal dystrophy on the graft 50 years after penetrating keratoplasty
title_short Recurrence of macular corneal dystrophy on the graft 50 years after penetrating keratoplasty
title_sort recurrence of macular corneal dystrophy on the graft 50 years after penetrating keratoplasty
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452946/
https://www.ncbi.nlm.nih.gov/pubmed/32884888
http://dx.doi.org/10.3205/oc000161
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