Abstract
To report an ultrastructurally distinct form of paraprotein crystalline keratopathy. Three corneas submitted from a single patient including one native cornea from each eye and a failed corneal graft from the right eye. Light microscopy, immunohistochemistry, immunofluorescence, and transmission electron microscopic examination were performed. The transmission electron microscopy showed "immunotactoid" extracellular microtubular deposits measuring >30 nm in diameter with a central lucent core. Immunotactoid keratopathy is a distinct type of paraprotein crystalline keratopathy associated with a monocolonal immunoglobulin G kappa light chain (IgGk) protein. Larger case series are needed to determine the clinical significance of this entity.
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