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Arch Ophthalmol. 1999;117:528-531.

Recurrence of macular corneal dystrophy after keratoplasty is rare. We report light microscopic, immunohistochemical, electron microscopic, and serologic findings in a 78-year-old woman who underwent regrafting 49 years following the first penetrating keratoplasty. Examination of the corneal button revealed deposits of glycosaminoglycans in the graft beneath the Bowman layer, throughout the stroma, and in the endothelium with positive staining for antigenic keratan sulfate. By transmission electron microscopy, intracellular and extracellular deposits of a fibrillogranular material were detected in the stroma, Descemet membrane, and endothelium. The serum level of antigenic keratan sulfate was normal. Our findings indicate that macular corneal dystrophy type II may show late recurrence after penetrating keratoplasty with intense deposition of antigenic keratan sulfate in all corneal layers.

Michael Küchle, MD; Claus Cursiefen, MD; Dagmar-Christiane Fischer, PhD; Ursula Schlötzer-Schrehardt, PhD; Gottfried O. H. Naumann, MD
From the Department of Ophthalmology and University Eye Hospital, University of Erlangen-Nürnberg, Erlangen, Germany (Drs Küchle, Cursiefen, Schlötzer, and Naumann); and the Department of Clinical Biochemistry and Pathobio-chemistry, University of Aachen, Aachen, Germany (Dr Fischer). Dr Fischer is now with the Department of Obstetrics and Gynecology, University of Freiburg, Freiburg, Germany.

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