Recurrence of keratoconus in donor cornea 22 years after successful keratoplasty.

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Abstract
A 2nd clinico-pathologic report of recurrent keratoconus in a 43 yr old white female, with bilateral penetrating keratoplasties for keratoconus, was presented. She had a recurrence of this condition in the right eye as manifested by increasing myopic oblique astigmatism, subepithelial and anterior stromal scarring and corneal thinning, 22 yr following the initial grafting procedure. A 2nd successful peentrating keratoplasty was performed. Light microscopy and EM demonstrated abnormalities in the basal epithelium, breaks in the basement membrane, duplication and thickening of Bowman''s layer, and abnormal stromal keratocytes with accumulation of granular intra- and extracellular material. These findings are consistent with changes as seen in keratoconus.

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