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A series of 35 patients manifested various configurations of the anterior cornea. Previous reports have consisted of less than ten patients, and have implied that this condition is relatively rare and innocuous. This report suggests that, because of its subtle appearance, the condition may be easily overlooked. Hence it may be more common than supposed. It may also cause considerable morbidity as a result of poor epithelial adherence and corneal surface irregularities. Preliminary therapeutic trials suggest that hypertonic agents like sodium chloride as well as mechanical debridement are effective in controlling recurrent corneal erosions.

A case of fingerprint corneal dystrophy with epithelial cysts has been studied histologically, using ultrathin sections for light and electron microscopy. Fingerprint lines that are ensheathed in normal basement membrane consist of a fibrillogranular protein apparently a product of the corneal epithelium. They are continuous with a subepithelial seam of similar, friable material thus accounting for the ready dehiscence and recurrent breakdown of the epithelium. Moribund cells stimulate fusion of epithelial cells to form multinucleate giant cells. These seclude degenerating cells that thus sequestered are taken by centripetal cell movement toward the tear film where they are discharged. The histologic evidence suggests that fingerprint dystrophy, the microcystic dystrophy of Cogan, and the recurrent erosion syndrome are closely related disorders.

Histopathologic examination of the epithelium from a patient with microcystic dystrophy showed an unusual basement insinuating into the midepithelial layer and a consequent entrapment of epithelial cells that are blocked in their forward migration. Ultimate evacuation of the cysts occurs with eventual rupture of the aberrant basement membranes. Surgical removal of the epithelium is indicated when the symptoms are sufficient to warrant it.