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A 50-year-old male presented with a history of bilateral recurrent corneal erosions and decreased vision to the level of 20/100. Slit-lamp examination revealed glasslike refractile branching lines throughout the corneal stroma, a diffuse anterior stromal haze, and areas of epithelial irregularity.
Lattice lines typically begin in the center of the cornea in the anterior stroma and spread centrifugally and into the deeper stroma. The refractile lines are best visualized with a slit lamp using retroillumination or against a red reflex.
Unhappy with his visual acuity, the patient was seeking corneal transplantation. The patient did undergo successful penetrating keratoplasty with an improvement in visual acuity. Although to date there is no evidence of lattice corneal dystrophy in the graft, there is a continued risk of recurrence, especially at approximately one decade after surgery.
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