Lamellar Crescentic Resection for Pellucid Marginal Corneal Degeneration

Abstract

PURPOSE: To evaluate the results of lamellar crescentic resection in pellucid marginal corneal degeneration. METHODS: Patients with pellucid marginal corneal degeneration who underwent lamellar crescentic resection from 1995 to 2000 at Labbafinejad Medical Center were assessed. Diagnosis was based on clinical findings of slit-lamp microscopy and confirmed by corneal topography and pachymetry. RESULTS: Fifteen eyes of nine patients (six male and three female) were operated. Mean patient age was 32 years (range 25 to 41 yr). Preoperatively, best spectacle-corrected visual acuity was 20/200 to 20/500 with a range of 12 to 26 D of against-the-rule astigmatism (mean 19.00 D). Follow-up ranged from 13 to 57 months (mean 35 mo). Postoperatively, patients had with-the-rule astigmatism: mean 16.00 D at 6 weeks and 10.50 D at 6 months. In the second postoperative year, mean with-the-rule astigmatism was 4.30 D. Best spectacle-corrected visual acuity was 20/40 in 71% of eyes at final follow-up. No significant complications occurred during the study period. CONCLUSION: Lamellar crescentic resection was a safe and effective non-penetrating surgical method to manage pellucid marginal corneal degeneration, however, visual recovery was relatively prolonged. [J Refract Surg 2004;20:162-165]

Current Options in the Management of Pellucid Marginal Degeneration

“…Crescentic lamellar wedge resection is similar to full-thickness crescentic wedge resection, but only the abnormally thinned stroma is removed, followed by re-approximation of the residual, normal-thickness stromal edges ( Figure 5). 83,84 Like full-thickness crescentic wedge resection, crescentic lamellar wedge resection does not require donor tissue. The main advantage of crescentic lamellar wedge resection over full-thickness crescentic wedge resection is the maintenance of a closed globe.…”

“…85 Several small studies have confirmed the efficacy of crescentic lamellar wedge resection in PMD ( Table 2). [83][84][85] Recently, Maccheron and Daya performed corneal wedge resection with partial or total lamellar dissection with the aim of improving corneal symmetry and optical clarity by shortening the vertical circumference of the cornea in eyes with combined PMD/keratoconus or keratoglobus. 85 The result was a statistically significant improvement in visual acuity with reduced astigmatism, although follow-up duration and outcomes varied among study participants.…”

Demographic, clinical and tomographic characteristics of pellucid marginal degeneration patients in South Egyptian population

“…The management of PMD includes various modalities of treatment, including spectacles, rigid gas-permeable contact lenses [ 6 ]. Surgical management includes intracorneal ring segments [ 7 ], full-thickness crescentic wedge resection [ 8 ], lamellar crescentic wedge resection [ 9 ], deep anterior lamellar keratoplasty [ 10 ], and penetrating keratoplasty (PK) [ 11 ].…”