Denovo development of corneal guttae and Fuchs' dystrophy in corneal grafts.

PURPOSE: To describe two cases of de novo development of corneal guttae and Fuchs' dystrophy in donor tissue following penetrating keratoplasty (PK) for unrelated conditions.

METHODS

Two patients underwent PK for keratoconus and a disciform scar secondary to herpes simplex virus. They were followed clinically for a period of 16 and 11 years, respectively. Specular microscopy was used in one patient.

RESULTS

Corneal guttae were first noted 10 years and 4 years following transplantation in the first and second patient, respectively. In both cases, the corneal guttae gradually increased in number, involving the central and temporal portions of the corneal graft There were no corneal guttae present in the host corneal rim or contralateral cornea of either patient.

CONCLUSIONS

These cases provide evidence to suggest that some corneas may be genetically predetermined to develop corneal guttae and Fuchs' dystrophy many years before any changes can be clinically detected.