KL and KC bi-mutational status correlated significantly with lymph node metastasis, as all (16/16) of the KL tumors and all but one (20/21) KC tumors were associated with lymph node metastasis 8.5% (16/188) and 10% (20/188) vs. 0% (0/60) and 1.7% (1/188) (p = 0.015) and (p = 0.03), respectively. The gene discussed is CALCA; the disease is keratoconus.