Primäre Lipidkeratopathie

Background A 73-year old man presented with a bilateral reduction of visual acuity which had slowly occurred over the last 20 years. Ophthalmologic examination revealed the presence of stromal opacifications which were denser in the central cornea associated with cataractous changes. His general history was remarkable for a status post polio infection in the early childhood and a medically treated arterial hypertension. We performed a triple procedure and histologic examination of the corneal button revealed the presence of a lipid keratopathy. Conclusion Lipid keratopathy is mostly caused by corneal vascularization or chronic inflammation or is a consequence of systemic disorders of lipid metabolisms. Our patient did not exhibit these underlying disorders and therefore we made the diagnosis of a primary lipid keratopathy. The underlying corneal pathomechanisms are incompletely understood but they should be limited to the corneal keratocytes.