Climatic Droplet Keratopathy Treating With Lamellar Keratoplasty

In this poster, we report a 49-year-old woman consulted for progressive vision loss in her right eye and diagnosed with a rare superficial corneal dystrophy disease named climatic droplet keratopathy (CDK) and recieved lamellar keratoplasty which resulted in promising outcome.

The Chinese PLA General Hospital, Beijing, China.

Patient was admitted to the hospital for treatment. A thorough preoperative ophthalmic examination were conducted to evaluate the condition of the patient's right eye. Slit lamp examination was conducted to observe the layers of the cornea and lesions morphology. Anterior segment OCT was conducted to measure corneal thickness, cornea lesion depth, and anterior chamber depth. The patient's right eye underwent  lamellar keratoplasty and the cornea lesions tissue was sent for Hematoxylin-Eosin staining.

Slit-lamp examination showed accumulation of coalescent, amber-colored, translucent globular deposits in the corneal stroma, extending horizontally from 4-o’clock position on the nasal side to the temporal side; and new vascular capillaries extended from the limbus at 4:30-o’clock position into the central lesion area of the cornea. Anterior segment OCT examination observed thickening of the corneal epithelium and corneal deposits. She was diagnosed with climatic droplet keratopathy and received lamellar keratoplasty. HE staining presented eosinophilic droplets, which did not extend through the Bowman membrane into the epithelium. Her best corrected visual acuity improved from 20/200 pre-surgery to 20/40 post-surgery.

CDK is characterized by degeneration of the cornea and progressive deposition of small, yellow-white droplets in the corneal epithelium, Bowman's layer, and anterior stroma. These droplets can cause visual impairment, discomfort, and corneal opacity. CDK is associated with chronic UV exposure, genetic factors, and environmental factors such as air pollution and dust. For patients with severe CDK and visual impairment, corneal transplantation surgery is needed. We report a patient diagnosed with CDK and underwent lamellar keratoplasty. Her best-corrected visual acuity succesfully improved from 20/200 pre-surgery to 20/40 post-surgery.