Secondary amyloidosis in a corneal graft.

PURPOSE To describe a case of secondary amyloidosis that occurred in a corneal graft. METHODS A 30-year-old Japanese woman had opacities in the corneal graft in her right eye. Slit-lamp microscopy examination demonstrated nodular, subepithelial opacities in the graft. Results of a physical examination and her past medical history were unremarkable, except for a history of a penetrating keratoplasty for keratoconus at the age of 17. Since then, the patient had worn a hard contact lens for over 10 years. The specimen obtained by keratectomy was examined histologically. RESULTS The histologic examination revealed hyaline, and amorphous materials stained with Congo red, which were dichroic under polarized light. Transmission electron microscopy showed the characteristic fibrillar pattern of amyloid. CONCLUSIONS This appears to be the first reported case of secondary amyloidosis in a corneal graft. A long-standing history of hard contact lens wear may play a role in the pathogenesis of this rare condition.