To evaluate a new surgical approach for the treatment of pellucid marginal corneal degeneration (PMCD).
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.
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.
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: firstname.lastname@example.org).