PMC4759509_01
(a) The clinical appearance of the right eye corneal vascularized mass. (b) The clinical appearance of the centrally clear corneal graft in the patient's left eye. (c) Ultrasound bio microscopy showing the large right corneal lesion approaching the iris centrally. (d) Ultrasound bio microscopy showing the same right eye lesion with shallow anterior chamber near the angle.
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The corneal mass was yellowish-pink in color, showed feeding blood vessels and obscured any further view of the anterior chamber and the posterior pole in his right eye (Fig. 1a). His left eye showed a centrally clear corneal graft with peripheral corneal haze and vascularization involving the edge of the graft (Fig. 1b). Ultrasound Bio microscopy (UBM) study of the right eye showed a large corneal lesion approaching the iris centrally with extremely shallow space between the lesion and the iris near the anterior chamber angle for 360 degrees (Fig. 1c  and  d).
(a) The histopathological appearance of the right corneal lesion with mixed infiltrate of lymphocytes and histiocytes in addition to significant vascularization. (Original magnification 100x, Hematoxylin & Eosin.) (b) Higher power of the foamy histiocytes. (Original magnification 400x, Hematoxylin & Eosin.) (c) The foamy histiocytes showing positive staining for CD 68. (Original magnification 400x.) (d) A Touton giant cell in the center of the histiocytic infiltrate. (Original magnification 400x, periodic acid Schiff.)
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The histiocytes were all positively stained with CD68 while showing negative staining with S-100 and CD 1a (Fig. 2a-d).
The clinical appearance of the right eye with cataract 1 year following his PKP.
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Unfortunately our patient developed cataract and secondary glaucoma 1 year after his PKP with evidence of peripheral anterior synechiae and iris-corneal touch (Fig. 3).