Abstract
Purpose A retrospective study to ascertain the management of pellucid marginal corneal degeneration (PMCD).
Method and results Sixteen patients (average age 42.6 years) presented with PMCD. PMCD was bilateral in 13 and unilateral in 3 patients. Eight eyes underwent surgery. Nineteen eyes were managed non-surgically. Surgery involved corneal wedge excision (WE) (6 eyes), penetrating keratoplasty (PK) (3 eyes) and lamellar thermo-keratoplasty (LTK) (1 eye). Immediate pre-operative average visual acuity (VA) was 6/24, 6/10 and 6/60 with an average pre-operative astigmatism of 11.40 D, 9.75 D and 20.5 D for WE, PK and LTK respectively. After an average post-operative follow-up of 57 months, 66 months and 1 year, the average astigmatism was 8.90 D, 4.63 D and 6.00 D with an average final VA of 6/19, 6/15 and 6/6 for WE, PK and LTK respectively. In the nonsurgical group, at presentation, 40% of eyes had a VA of 6/12 or better. After an average follow-up period of 32.3 months, 80% of eyes had a visual acuity of 6/12 or better. Optical correction was achieved with spectacles and or contact lenses.
Conclusions Surgical correction for PMCD provides poor long-term reduction of astigmatism. Patients with PMCD may be adequately corrected in the long term by the use of scleral fitted gas-permeable contact lenses.
References
Krachmer JH . Pellucid marginal corneal degeneration. Arch Ophthalmol 1978;96:1217–21
Taglia DP, Sugar J . Superior pellucid marginal corneal degeneration with hydrops. Arch Ophthalmol 1997;115:274–5
Cameron JA, Mahmood MA . Superior thinning with pellucid marginal corneal degeneration. Am J Ophthalmol 1990;109:486–7
Schlaeppi V . La dystrophie marginale inférieure pellucide de la cornée. Prob Act Ophtalmol 1957;1:672–4
Krachmer JH, Feder RS, Belin MW . Corneal thinning disorders: a synopsis. Surv Ophthalmol 1984;28:293–322
Maguire LJ, Klyce SD, McDonald MB, Kaufman HE Corneal topography of pellucid marginal degeneration. Ophthalmology 1987;94:519–24
Schanzlin DJ, Sarno EM, Robin JB . Crescentic lamellar keratoplasty for pellucid marginal degeneration. Am J Ophthalmol 1983;96:253–4
Carter JB, Jones DB, Wilhelmus KR . Acute hydrops in pellucid marginal corneal degeneration. Am J Ophthalmol 1989;107;167–70.
Karabatsas CH, Cook SD . Topographic analysis in pellucid marginal corneal degeneration and keratoglobus. Eye 1996;10:451–5
Ezekiel D . Gas permeable scleral lenses. Spectrum 1991[July]:19–24.
Schein OD, Rosenthal P, Ducharme C . A gas permeable scleral contact lens for visual rehabilitation. Am J Ophthalmol 1990;109:318–22
Tan DTH, Pullum KW, Buckley RJ . Medical applications of scleral contact lenses. 2. Gas-permeable scleral contact lenses. Cornea 1995;14:130–7
Pullum KW, Buckley RJ . A study of 530 patients referred for rigid gas permeable scleral contact lens assessment. Cornea 1997;16:612–22
Tromans C, Bullock JB, Tullo AB, Ridgway AEAR . Evaluation of gas permeable scleral contact lenses. Invest Ophthalmol Vis Sci 1996;37:S75.
Maclean H, Robinson LP, Wechsler AW . Long-term results of corneal wedge excision for pellucid marginal degeneration. Eye 1997;11:613–7
Speaker MG, Arentsen JJ, Laibson PR . Long-term survival of large diameter penetrating keratoplasties for keratoconus and pellucid marginal degeneration. Acta Ophthalmol 1989;67 (Suppl 192):17–9.
Epstein RJ, Seeder JA, Dreizen NG, et al . Penetrating keratoplasty for herpes simplex keratitis and keratoconus. Ophthalmology 1987;94:935–44
Varley GA, Macsai MS, Krachmer JH . The results of penetrating keratoplasty for pellucid marginal corneal degeneration. Am J Ophthalmol 1990;110:145–52
Cameron JA . Results of lamellar crescentic resection for pellucid marginal degeneration. Am J Ophthalmol 1992;113:296–302
Fronterre A, Portesani GP . Epikeratoplasty for pellucid marginal corneal degeneration. Cornea 1991;10:450–3
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Biswas, S., Brahma, A., Tromans, C. et al. Management of pellucid marginal corneal degeneration. Eye 14, 629–634 (2000). https://doi.org/10.1038/eye.2000.155
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DOI: https://doi.org/10.1038/eye.2000.155
Keywords
- Pellucid marginal corneal degeneration
- Penetrating keratoplasty
- Refractive surgery
- Scleral contact lens
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