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[Two cases of snowflake-like keratitis].

L Bredow1, T Reinhard, C Auw-Hädrich

  • 1Universitäts-Augenklinik Freiburg, Killianstr. 5, Freiburg, Deutschland. laura.bredow@uniklinik-freiburg.de

Der Ophthalmologe : Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft
|June 11, 2010
PubMed
Summary

Infectious crystalline keratopathy (ICK) presented as snowflake-like or thread-like corneal opacification in two patients without significant inflammation. Bacterial presence in corneal grafts necessitated regrafting for visual recovery.

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Area of Science:

  • Ophthalmology
  • Microbiology
  • Corneal Transplantation

Background:

  • Corneal allografts are susceptible to various complications following transplantation.
  • Infectious crystalline keratopathy (ICK) is a rare form of microbial keratitis characterized by a distinctive crystalline appearance.
  • Prompt diagnosis and management are crucial for preserving visual function in patients with corneal complications.

Observation:

  • Two patients developed unusual corneal opacities after corneal grafting procedures.
  • Patient 1 presented with snowflake-like keratitis, while Patient 2 showed thread-like opacifications that rapidly progressed.
  • Both cases lacked a significant inflammatory response, a key feature of ICK.

Findings:

  • Histological examination revealed dense Gram-positive bacterial populations within the interlamellar spaces of the excised corneas.

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  • The bacterial morphology and location were consistent with infectious crystalline keratopathy.
  • Regrafting was required in both patients to address the corneal opacification and restore vision.

    • Implications:

    • This case series highlights the presentation of infectious crystalline keratopathy in corneal allografts.
    • The findings underscore the importance of considering atypical microbial infections in post-keratoplasty patients.
    • Effective management strategies, including regrafting, are essential for treating ICK in compromised corneas.