IgG-κ Immunoglobulin Deposits Involving the Predescemetic Region in a Patient With Multiple Myeloma

PURPOSE:To report the clinico-pathologic features of corneal deposits in a patient with multiple myeloma with surgical intervention and follow-up. DESIGN:Interventional case report. METHODS:We reviewed the patientʼs chart and the relevant literature on immunoglobulin corneal deposits and its prognosis. RESULTS:A 52-year-old man with a history of multiple myeloma underwent penetrating keratoplasty sequentially for decreased vision in both eyes secondary to abnormal corneal deposits. Pathologic examination of the keratectomy specimens, including immunohistochemistry and transmission electron microscopy, revealed IgG-κ immunoglobulin deposits in the predescemetic region in both corneas. After keratoplasty, he regained excellent vision in both eyes, which was maintained at the end of 18 months of follow-up in both eyes despite early signs of recurrence in the right eye. His systemic condition was well controlled during the period of follow-up. CONCLUSION:Corneal deposits in multiple myeloma are well described in the literature, but there are few reports regarding the prognosis and visual function after penetrating keratoplasty. Our report shows that when the systemic condition is well controlled, penetrating keratoplasty has an excellent prognosis in these patients.