Nonfamilial anterior corneal dystrophy

A 31-year-old woman with subepithelial corneal opacification and numerous clear round or oval areas of epithelial edema confined to the palpebral fissure underwent a penetrating keratoplasty. The clinical appearance was similar to that of a severe Meesmann or Stocker-Holt dystrophy. The prominent histopathologic features were thickening and excrescences of the epithelial basement membrane, intense basal cell edema, but no intraepithelial cysts. The basement membrane changes are compatible with those seen in Meesmann, Stocker-Holt, and map-dot-fingerprint dystrophy, but the lack of intraepithelial cysts is not characteristic of these dystrophies. This case represents a variant of the known anterior corneal dystrophies which have an overproduction of epithelial basement membrane.