Avellino Corneal Dytrophy Worening after Laer In itu Keratomileui: Further Clinicopathologic Obervation and Propoed Pathogenei Original Reearch Article

Purpoe To tudy the nature of the depoit in Avellino corneal dytrophy (ACD) worening after laer in itu keratomileui (LAIK), and ugget a mechanim for hitopathogenei. Deign Interventional cae report. Method A 28-year-old woman previouly diagnoed with bilateral ACD underwent bilateral LAIK. The corneal dytrophy progreively worened bilaterally, one year later. A penetrating keratoplaty wa ubequently performed on the right eye at 31 year of age, and in the left eye a year later. The clinical and hitopathologic finding of the corneal graft of the right eye were reported in the literature, with poitivity to the Maon trichrome tain, negative taining with Congo red, and heterozygoity for the Arg124Hi mutation by erum DNA tudie. Hitopathologic tudie of the corneal graft of the left eye were conducted at the Univerity of Texa outhwetern Medical Center. Reult Hitopathologic examination of the excied cornea howed the Maon trichrome poitive depoit preent from underneath the Bowman layer to the LAIK interface, with abence of depoit poterior to the latter. In contrat to the prior report decribing finding in the corneal graft of the left eye, the depoit tained lightly with Congo red, but failed to how birefringence under polarized light, or fluorecence with thioflavin T. Concluion Accelerated depoit developing after LAIK in ACD eye eem to harbor pre-amyloid feature. The epithelium i likely to be the culprit, in a pathway independent of with human tranforming growth hormone beta (TGF-beta), with depoit developing in the anterior troma and the tromal interface.