Bilateral recurrent calcareous degeneration of the cornea.
OBJECTIVE
To report clinical, histologic, and electron microscopic findings in several consecutive keratoplasties with recurrent pancorneal calcification in a patient with chronic graft versus host disease and severe keratoconjunctivitis sicca following bone marrow transplantation for chronic myelogenous leukemia.


METHODS
Altogether 5 penetrating keratoplasties were performed in both eyes for descemetocele formation and corneal perforation as well as pancorneal calcification associated with severe visual loss. Histologic examination and electron microscopy were performed on the corneal buttons obtained.


RESULTS
Histology and electron microscopy confirmed pancorneal extracellular calcium deposition with increasing severity in each consecutive keratoplasty. Calcification was associated with necrosis and inflammation of the corneal stroma. Clinically unsuspected fungal keratitis was observed in 1 specimen.


CONCLUSIONS
Keratoconjunctivitis sicca, epithelial defects, corneal inflammation, and infection are most probably responsible for the recurrent pancorneal calcification seen in our patient. The role of cytokines in this complication is discussed.
Messmer
Elisabeth M
EM
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. emessmer@med.uni-muenchen.de
Hoops
Jan P
JP
Kampik
Anselm
A
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002114:Calcinosis / Q000209:etiology* / Q000473:pathology; D002908:Chronic Disease; D003316:Corneal Diseases / Q000209:etiology* / Q000473:pathology; D016039:Corneal Transplantation; D019573:Epithelium, Corneal / Q000473:pathology; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications; D006801:Humans; D007634:Keratitis / Q000150:complications / Q000382:microbiology; D007638:Keratoconjunctivitis Sicca / Q000150:complications; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000601:surgery*; D008854:Microscopy, Electron; D009181:Mycoses; D009336:Necrosis; D012008:Recurrence; D012086:Reoperation