Recurrent Meesmann's corneal epithelial dystrophy after penetrating keratoplasty.
OBJECTIVE
To characterize the histopathology of recurrent Meesmann's corneal epithelial dystrophy after penetrating keratoplasty.


METHODS
Postmortem examination by light and electron microscopy of the eyes of an 84-year-old patient with Meesmann's dystrophy who underwent a penetrating keratoplasty in the right eye at age 74 years and a lamellar keratoplasty in the left eye at age 51 years.


RESULTS
In the right eye, the characteristic features of Meesmann's dystrophy were demonstrated in both the donor and recipient corneas. The pathologic findings were limited to the corneal epithelium and included increased thickness, architectural disorganization, loss of cell polarity, increased amounts of intracellular glycogen, presence of intraepithelial microcysts containing degenerated cells, and in some cells, the presence of an electron-dense fibrillogranular material associated with disrupted cytoplasmic filaments. In the left eye, the corneal findings were consistent with but not specific for Meesmann's dystrophy. These included architectural disorganization, loss of cell polarity, presence of intraepithelial microcysts, and irregular thickening of the basement membrane in the donor cornea.


CONCLUSIONS
Meesmann's corneal epithelial dystrophy is demonstrated to recur after penetrating keratoplasty. This finding suggests that the abnormalities that lead to the disease are localized to the corneal epithelial cells and not in the stroma, as previously proposed.
Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University, New York, New York 10032, USA.
A G
AG
Chiou
G J
GJ
Florakis
R L
RL
Copeland
V A
VA
Williams
S A
SA
McCormick
R
R
Chiesa
D000368:Aged; D000369:Aged, 80 and over; D003317:Corneal Dystrophies, Hereditary / Q000209:etiology / Q000473:pathology*; D019573:Epithelium, Corneal / Q000473:pathology*; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D010375:Pedigree; D012008:Recurrence