J Korean Ophthalmol Soc.  2014 Aug;55(8):1238-1241.

Posterior Polymorphous Corneal Dystrophy (PPCD) Combined with Traumatic Descemet's Membrane Fold

• Kim NH
• Shin JY
• Kim MS

Abstract

PURPOSE
To present a case of a 72-year-old woman with posterior polymorphous corneal dystrophy (PPCD) combined with traumatic Descemet's membrane fold due to forceps injury in Birth.
CASE SUMMARY
A 72-year-old woman without significant ocular history presented complaining of ocular discomfort in her right eye. She had a history of birth that required forceps delivery and poor vision in the right eye since childhood. The rest of perinatal ophthalmic history was unremarkable (no past ophthalmic or family history). The best corrected visual acuity was 20/20 in both eyes. Slit-lamp biomicroscopy showed distinctive, vertical, semitranslucent Descemet's membrane breaks situated on the superior temporal side of the posterior surface of the cornea in her right eye. Also, a horizontal, tram-track line appearance of posterior cornea surface was detected at middle and inferior side of cornea. The fellow eye was normal. The endothelial cell densities were 945 cells/mm2 and 2481 cells/mm2 in right and left eyes, respectively. After 11 years later, (routine follow up exams every 1 year), the endothelial cell densities were 901 cells/mm2 and 2481 cells/mm2 in right and left eyes, respectively, which means there were no significant changes of endothelial densities in both eyes.
CONCLUSIONS
We report a case of a patient with posterior polymorphous corneal dystrophy (PPCD) combined with traumatic Descemet's membrane fold due to forceps injury in Birth. The disease does not seem to progress or aggravated in long term follow up and no specific treatment was required.

Keyword

Descemet's membrane; Endothelial cells; Forceps injury; Posterior polymorphous corneal dystrophy; Progression

MeSH Terms

Aged
Cornea
Descemet Membrane*
Endothelial Cells
Female
Follow-Up Studies
Humans
Parturition
Surgical Instruments
Visual Acuity

Figure

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  Figure 1. Slit-lamp photograph of glasslike lines on the posterior surface of the cornea (red arrow). As showed in the figure, distinctive, vertical and semitranslucent Descemefs membrane breaks situated on the superior temporal side of the posterior surface of the cornea which is a typical characteristic of traumatic Descemefs membrane fold due to forceps injury in Birth.

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  Figure 2. Tram-track line appearance (red arrow) in posterior polymorphous corneal dystrophy (PPCD) on Slit lamp exam. The lesion is located at middle and inferior side of posterior cornea.

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  Figure 3. Specular microscopy of the right eye showed a low endothelial count (945 and 901 cells/mm2) as well as endothelial cells of variable shape and size (polymorphism and polymegathism). (A) Initial visit, (B) last visit (after 11 years). The figures show that there was no significant change of endothelial densities during 11 years.

Reference

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