This report aims to establish a clinico-pathological correlation in the diagnosis of a patient with bilateral endothelial corneal deposits. A 65-year-old female presented with bilateral decreased vision, glare, and photophobia for 3 months. Visual acuity at the presentation was 20/60 in the right eye and 20/40 in the left eye. A compact cornea, along with diffuse, elevated plaques on the endothelium, was seen in both eyes (right > left). On anterior segment optical coherence tomography (ASOCT), elevated lesions were seen on the endothelium along the mid-peripheral cornea. Reduced endothelial cell count was seen on specular microscopy in both eyes. Descemet membrane endothelial keratoplasty (DMEK) was done in the right eye along with phacoemulsification. During surgery, the deposits felt hard to touch but could be removed. At the 1-month follow-up visit, visual acuity improved to 20/30 in the right eye along with a compact cornea. On histopathological examination, Descemet’s membrane (DM) showed vesicle formation and deposits along the line of DM. On immunohistochemistry (IHC), these deposits were stained for cytokeratin. This confirmed the diagnosis of posterior polymorphous corneal dystrophy (PPCD). This report highlights that PPCD can be successfully managed with endothelial keratoplasty, and even elevated hard keratin deposits can be removed intra-operatively.
Jain et al. (2026) studied this question.