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Secondary amyloidosis in a corneal graft
Masakazu Yamada1, Takatsune Nishiyama, Minako Konishi
1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Purpose:
To describe a case of secondary amyloidosis that occurred in a corneal graft.
Methods:
A 30-year-old Japanese woman had opacities in the corneal graft in her right eye. Slit-lamp microscopy examination demonstrated nodular, subepithelial opacities in the graft. Results of a physical examination and her past medical history were unremarkable, except for a history of a penetrating keratoplasty for keratoconus at the age of 17. Since then, the patient had worn a hard contact lens for over 10 years. The specimen obtained by keratectomy was examined histologically.
Results:
The histologic examination revealed hyaline, and amorphous materials stained with Congo red, which were dichroic under polarized light. Transmission electron microscopy showed the characteristic fibrillar pattern of amyloid.
Conclusions:
This appears to be the first reported case of secondary amyloidosis in a corneal graft. A long-standing history of hard contact lens wear may play a role in the pathogenesis of this rare condition.