Early Recurrence of Macular Corneal Dystrophy Including Electron Microscopic Observations

Abstract

A 70-year-old man had a history of corneal dystrophy and in 1955 underwent a penetrating keratoplasty of the left eye. Six years later, a penetrating keratoplasty was performed in the right eye. Several years later, he developed decreased vision in his left eye due to cataract formation. In May 1985, the patient had an extracapsular cataract extraction with intraocular lens implantation in the left eye. Slit-lamp examination of the left cornea 2 months later showed stromal edema with faint, grayish-white opacities that extended from the donor-host interface into the periphery of the graft. The clinical diagnosis was endothelial cell decompensation with stromal edema and recurrent macular corneal dystrophy (MCD). Histopathologic examination of the left corneal graft showed early recurrence of MCD extending from the donor-host interface into the periphery of the donor cornea. Histochemical and electron microscopic studies confirmed the diagnosis of recurrent MCD. A review of the literature disclosed only eight histopathologically proven cases of MCD.