Combined wedge resection and beveled penetrating relaxing incisions for the treatment of pellucid marginal corneal degeneration.
OBJECTIVE
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.
Department of Ophthalmology, Villa Serena Hospital, Forli, Italy. mbusin@yahoo.com
Massimo
M
Busin
Yves
Y
Kerdraon
Vincenzo
V
Scorcia
Luca
L
Zambianchi
Stefania
S
Matteoni
D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000503:physiopathology / Q000517:prevention & control; D003317:Corneal Dystrophies, Hereditary / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology