Histochemical and electron microscopic evaluation of the effect of dimethyl sulfoxide on gelatinous droplike corneal dystrophy

At present, surgery is the only effective treatment for gelatinous droplike corneal dystrophy (GDCD). However, the rate of recurrence is high. We used a novel treatment in the case of a patient in whom GDCD recurred after lamellar keratoplasty in both eyes and penetrating keratoplasty in the right eye. A solution of 1.0% dimethyl sulfoxide (DMSO) was prescribed, to be applied topically three times a day. Slit-lamp examination after 1 month of topical applications of DMSO revealed significant reduction in the number of gelatinous droplike nodules and in corneal opacity and no notable changes in the corneoscleral rim. After a months of treatment with DMSO, penetrating keratoplasty was performed in both eyes to improve visual acuity. When we examined this patient's corneas by light and electron microscopy we found no amyloid deposits in the grafted area, but histochemical and electron microscopy analysis revealed accumulation of amyloid at the corneoscleral rim in each eye. The results in this case suggest that a 1.0% solution of DMSO helps prevent recurrence of GDCD.