title: Early pellucid marginal corneal degeneration: case reports of two refractive surgery candidates.
abstract: OBJECTIVE
  To report two refractive surgery candidates who demonstrated early corneal topographic findings of pellucid marginal degeneration.
  
  
  METHODS
  Case reports.
  
  
  RESULTS
  Two candidate patients for corneal laser surgery were examined. The patients had normal examinations, including normal slit lamp biomicroscopy results and corrected visual acuity that was 20/20 or better in each eye. The corneal topography in one eye of patient I and both eyes of patient 2 was characterized by the presence of irregular astigmatism and inferior corneal steepening with a pattern consistent with pellucid marginal degeneration. Marked asymmetry between the eyes was noted. The inferior cornea was thinner than the central cornea in both eyes of each patient.
  
  
  CONCLUSIONS
  Patients with early corneal ectasia often present as refractive surgery candidates with normal corrected visual acuity and normal pachymetry of the central cornea. Corneal topography and regional pachymetry measurements can be used to identify these patients. Patients with pellucid marginal degeneration are not good candidates for refractive surgery because of the potential for poor outcomes and the possibility that iatrogenic thinning of the cornea could lead to progression of the disease.
authors.affiliation: Department of Ophthalmology, University of Washington, Seattle 98195, USA.
authors.forename: Renato
authors.initials: R
authors.lastname: Ambrósio
authors.forename: Steven E
authors.initials: SE
authors.lastname: Wilson
mesh_terms: D000368:Aged; D003315:Cornea / Q000473:pathology* / Q000601:surgery; D003317:Corneal Dystrophies, Hereditary / Q000175:diagnosis* / Q000601:surgery; D019781:Corneal Topography; D004108:Dilatation, Pathologic / Q000175:diagnosis; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy