title: Management of pellucid marginal corneal degeneration.
abstract: OBJECTIVE
  A retrospective study to ascertain the management of pellucid marginal corneal degeneration (PMCD).
  
  
  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.
authors.affiliation: Royal Eye Hospital, Manchester, UK.
authors.forename: S
authors.initials: S
authors.lastname: Biswas
authors.forename: A
authors.initials: A
authors.lastname: Brahma
authors.forename: C
authors.initials: C
authors.lastname: Tromans
authors.forename: A
authors.initials: A
authors.lastname: Ridgway
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000628:therapy; D003261:Contact Lenses; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity