Primary Lipidic Degeneration of the Cornea

Light-microscopic and transmission-electron-microscopic studies were performed on corneal buttons obtained after keratoplasty from a 68-year-old white woman who had presented with decreasing visual acuity secondary to bilateral dense corneal opacities. We found lipidic material diffusely and densely distributed extracellularly in the posterior and inferior aspect of the corneal stroma, with no evidence of corneal vascularization and no serum lipid elevation. There was no known involvement of other family members. The findings support the concept that primary lipidic degeneration of the cornea represents an exaggeration of arcus senilis.