title: Keratoconus associated with other corneal dystrophies.
abstract: OBJECTIVE
  To report the concomitant presentation of keratoconus and corneal dystrophies at Wills Eye Hospital for the 10-year period from January 1, 1997, to December 31, 2006.
  
  
  METHODS
  Patients with concomitant keratoconus and corneal dystrophies were identified using a computer database. Complete ophthalmologic examination, keratometry, pachymetry, and computerized videokeratography were performed in all patients. When present, cornea guttata were confirmed by clinical examination and specular microscopy. Histopathologic examination with special stains of excised corneal buttons was performed.
  
  
  RESULTS
  Fifty-one patients manifested typical signs and topographic evidence of keratoconus associated with another corneal dystrophy. Fuchs dystrophy was the most common association accounting for 27 cases (52.9%), followed by anterior basement membrane dystrophy with 13 cases (25.5%) and posterior polymorphous dystrophy with 7 cases (13.8%). A bilateral combination of Fuchs dystrophy and anterior basement membrane dystrophy with keratoconus was seen in 3 cases (5.8%). Finally, there was 1 bilateral case (2%) of granular dystrophy. Histopathologic studies in cases that underwent penetrating keratoplasty confirmed the clinical diagnoses.
  
  
  CONCLUSIONS
  To our knowledge, this is the largest report of such a concurrence in the English literature and could lead to further studies on the possible pathophysiologic or genetic links between these entities, although a chance association cannot be excluded.
authors.affiliation: Cornea Service, Wills Eye Institute, Philadelphia, PA 19107, USA.
authors.forename: Federico A
authors.initials: FA
authors.lastname: Cremona
authors.forename: Faris R
authors.initials: FR
authors.lastname: Ghosheh
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Rapuano
authors.forename: Ralph C
authors.initials: RC
authors.lastname: Eagle
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Hammersmith
authors.forename: Peter R
authors.initials: PR
authors.lastname: Laibson
authors.forename: Brandon D
authors.initials: BD
authors.lastname: Ayres
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003317:Corneal Dystrophies, Hereditary / Q000150:complications* / Q000473:pathology; D019781:Corneal Topography; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000150:complications; D006801:Humans; D007640:Keratoconus / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies