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: firstname.lastname@example.org).