A case of infectious crystalline keratopathy occurring long after penetrating keratoplasty

Purpose. To report a 64-year-old woman's case of infectious crystalline keratopathy (ICK) that occurred 9 years after the penetrating keratoplasty (PKP). Methods. This study includes clinical history and histopathologic findings of the case. Results. As historic background, the patient underwent PKP for lattice dystrophy and later, persistent epithelial defect occurred on the graft. Topical steroid treatment and a therapeutic soft contact lens were applied; however, ICK developed and second PKP was performed. In the ICK region, yeasts were cultured and histologically, degenerated keratocytes containing yeast particles surrounded the intralamellar plaques of yeasts without accompanying inflammatory cells. Conclusion. This case is possibly the first to develop ICK long after PKP. Histologically, ICK presumably occurred based on the immunologically incompetent condition, and, by verifying the previous reports, the neurotrophic background after PKP may partially be involved in the development of ICK.