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Infectious crystalline keratopathy: an electron microscope analysis.

J R Samples, S D Baumgartner, P S Binder

|January 1, 1985

Summary

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A rare crystalline stromal keratopathy in a corneal transplant patient was linked to a low-grade bacterial infection. Early antibiotic treatment is crucial for managing this condition.

Area of Science:

Ophthalmology
Microbiology
Pathology

Background:

Corneal transplantation is a common procedure, but complications can arise.
Crystalline stromal keratopathy is a rare condition affecting corneal transparency.

Observation:

A 73-year-old male developed crystalline stromal keratopathy after his second corneal transplant.
The condition worsened despite broad-spectrum antibiotic and antifungal treatment.
Histopathologic examination revealed bacterial cell walls and unique electron-dense bodies.

Findings:

The causative agent was identified as bacteria with a characteristic trilamellar cell wall structure.
Electron microscopy showed small, electron-dense bodies with needle-like projections, potentially causing the crystalline appearance.

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Bacterial presence was localized to the anterior corneal stroma.

Implications:

Crystalline stromal keratopathy may indicate an underlying low-grade bacterial infection.
Prompt diagnosis through cultures and aggressive antibiotic therapy are recommended.
This finding highlights the importance of considering microbial causes in post-keratoplasty stromal opacities.