meesmann corneal dystrophy: a clinico-pathological and ultrastructural case report

purpose: to report the clinico-pathological and ultrastructural features of a case of meesmann corneal dystrophy (mcd). case report: a 10-year-old boy presented with decreased vision in both eyes since early childhood. slitlamp biomicroscopy disclosed diffuse intraepithelial microcystic changes in the cornea but other layers appeared unremarkable. high pathologic myopia and amblyopia were other abnormal clinical findings. the patient underwent automated lamellar therapeutic keratoplasty (altk) in the left eye with a probable clinical diagnosis of mcd. the corneal button underwent histopathologic and trans-mission electron microscopic examinations. histopathologic examination disclosed abnormal appearing corneal epithelium with intracytoplasmic cyst-like inclusions and cellular swelling. the cells contained moderate amounts of pas-positive and diastase-sensitive material consistent with glycogen. on trans-mission electron microscopy, numerous vacuoles of variable size were present within the cytoplasm throughout the entire epithelium. moderate numbers of intracytoplasmic electron-dense and mem-brane-bound bodies similar to lysosomes were also noted, some engulfed by the vacuoles. visual acuity in left eye was slightly improved postoperatively, but intraepithelial microcystic changes recurred after one year. conclusion: to our knowledge, this is the first report of meesmann corneal dystrophy from iran describing the typical clinico-pathologic and ultrastructural features of this recurrent condition