PMC6324110_01
(a) Slit lamp photograph of the right eye showing whitish deposits at the peripheral cornea in a circumferential pattern; (b) slit lamp photograph of the left eye showing similar deposits in the left eye; (c) specular microscopy of the right eye showing a non-readable image in the right eye; (d) specular microscopy of the left eye showing reduced endothelial cell density, increased mean cell area and guttae; (e) anterior segment optical coherence tomography of the right eye showing thickened Descemet membrane and deposits at the posterior membrane level; (f) anterior segment optical coherence tomography of the left eye showing similar features as seen in the right eye
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F1
Slit lamp examination revealed whitish deposits at deep posterior stroma and Descemet membrane-endothelial complex scattered circumferentially in the peripheral cornea [Fig. 1a and b]. Specular microscopy was not readable in the right eye and showed reduced endothelial cell density and guttae in the left eye [Fig. 1c and d]. Anterior segment optical coherence tomography (OCT, Optovue) revealed a thick Descemet membrane with nodular changes [Fig. 1e and f].
(a) Slit lamp photograph of the left eye on postoperative day 5 after simultaneous phacoemulsification with intraocular lens and Descemet stripping endothelial keratoplasty; (b) anterior segment optical coherence tomography showing the Descemet stripping endothelial keratoplasty graft in place; (c) histology of the stripped Descemet membrane showing alcian blue positive deposits of glycosaminoglycans consistent with the clinical diagnosis of macular corneal dystrophy
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F2
Descemet stripping endothelial keratoplasty (DSEK) was performed along with cataract surgery in the left eye [Fig. 2a and b]. The histology of the stripped Descemet membrane showed alcian blue positive deposits along the endothelial cells [Fig. 2c].