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Authors: Wasielica-Poslednik, Joanna
Gericke, Adrian
Desuki, Alexander
Schlötzer-Schrehardt, Ursula
Pfeiffer, Norbert
Lisch, Walter
Title: Recurrence of paraproteinemic keratopathy after penetrating keratoplasty and its assessment with confocal microscopy
Online publication date: 19-Dec-2018
Language: english
Abstract: Purpose To report on a case of recurrence of paraproteinemic keratopathy (PPK) associated with monoclonal gammopathy after bilateral penetrating keratoplasty. Observations Penetrating keratoplasty was performed on both eyes of a 45-year-old man due to bilateral progressive corneal stromal clouding. Recurrence of the corneal stromal opacities accompanied by a decrease in visual acuity was observed on slit-lamp examination already two years after penetrating keratoplasty. Confocal laser scanning microscopy (CLSM) of the corneal grafts performed three years after penetrating keratoplasty showed bilateral morphological changes identical to that found in the patient's corneas prior to penetrating keratoplasty. A hematological work-up revealed monoclonal gammopathy of type IgG kappa. The histochemical examination of the explanted corneas confirmed the diagnosis of PPK. Conclusions and importance Paraproteinemic keratopathy is an underdiagnosed ophthalmological condition, which may be associated with potentially life-threatening hematologic disorders. A hematological workup should be performed in patients with corneal opacities of uncertain etiology. Penetrating keratoplasty should be performed with caution in patients with monoclonal gammopathy due to the possibility of a very fast recurrence of PPK in the corneal graft. This is the first presentation of the recurrence of flake like PPK after penetrating keratoplasty assessed with CLSM.
DDC: 610 Medizin
610 Medical sciences
Institution: Johannes Gutenberg-Universität Mainz
Department: FB 04 Medizin
Place: Mainz
URN: urn:nbn:de:hebis:77-publ-587133
Version: Published version
Publication type: Zeitschriftenaufsatz
License: CC BY-NC-ND
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Journal: American journal of ophthalmology : Case reports
Pages or article number: 87
Publisher: Elsevier
Publisher place: Amsterdam
Issue date: 2018
ISSN: 2451-9936
Publisher URL:
Publisher DOI: 10.1016/j.ajoc.2018.06.014
Appears in collections:JGU-Publikationen

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