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Combined Wedge Resection and Beveled Penetrating Relaxing Incisions for the Treatment of Pellucid Marginal Corneal Degeneration

Busin, Massimo MD; Kerdraon, Yves MD; Scorcia, Vincenzo MD; Zambianchi, Luca MD; Matteoni, Stefania MD

doi: 10.1097/ICO.0b013e318166c40c
Technique

Purpose: To evaluate a new surgical approach for the treatment of pellucid marginal corneal degeneration (PMCD).

Methods: Prospective, noncomparative, interventional case series. Ten eyes of 10 consecutive patients were included in the series. Inclusion criteria were a clinical diagnosis of PMCD, topographic astigmatism >10 D, and contact lens intolerance. The patients underwent an inferior arcuate wedge resection of the thinned cornea (0.5 mm wide, 6.0 mm long) combined with 2 penetrating, sutureless, clear corneal tunnel relaxing incisions (3.2 mm wide) at the steep meridians.

Results: Visual acuity, refraction, and corneal topography were assessed preoperatively and at 1, 3, 6, 12, and 24 months postoperatively. Suture removal was complete in all patients by 4 months. Spectacle-corrected visual acuity was 20/40 or better in 8 of 10 patients at 6 months, with no substantial change at later examinations. Mean keratometric astigmatism was reduced from 15.1 D preoperatively to 4.6 D at 6 months postoperatively and was stable at further follow-ups.

Conclusions: Corneal wedge resection combined with paired, opposed clear corneal penetrating relaxing incisions is a suitable surgical option for the treatment of PMCD, providing early adequate astigmatic control with long-term stability.

From the *Department of Ophthalmology, Villa Serena Hospital, Forli, Italy; the †Department of Ophthalmology, Università della Magna Graecia, Catanzaro, Italy; and the ‡Save Sight Institute, University of Sydney, Sydney, Australia.

Received for publication August 23, 2007; revision received November 15, 2007; accepted December 23, 2007.

Presented in part at the American Academy of Ophthalmology Annual Meeting, Chicago, IL, October 15-18, 2005.

The authors state that they have no proprietary interest in the products named in this article.

Reprints: Massimo Busin, “Villa Serena” Hospital, Department of Ophthalmology, Forli, Italy (e-mail: mbusin@yahoo.com).

Copyright © 2008 Wolters Kluwer Health, Inc. All rights reserved.