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Terrien marginal degeneration: a long-term follow-up

Poster Details

First Author: C.Comas Bedmar SPAIN

Co Author(s):    N. Barnils Garcia   E. Millan Valbuena   T. Marti Huguet        

Abstract Details



Purpose:

To report our clinical results, complications and surgical techniques of patients affected of Terrien marginal degeneration (TMD) in Hospital Universitari de Bellvitge (Barcelona) over the past 20 years.

Setting:

Hospital Universitari de Bellvitge is a tertiary hospital located in Barcelona (Spain). It services pacients from the surroundings of Barcelona and complex cases referred from the rest of Catalonia and Spain. The ophthalmology service is divided into subspecialities to fit better patients necessities.

Methods:

We report a serial of 7 patients (5 men and 2 women), all of them affected of TMD and followed by the anterior segment department of our hospital, between 1993 and 2013. The 7 patients (14 eyes) with the diagnosis of TMD had a mean follow-up of 12.8 years [3-20]. The mean age of diagnosis of these patients was 45.1 years old [25-63]. The mean age of diagnosis in women was 59.5 years old [56-63]. Men presented a younger mean age of diagnosis at 39.4 years old [25-57]. All patients that were included in the study had bilateral affection, with certain asymmetry. At the moment of presentation, the mean (BCVA) best-corrected visual acuity was 0.86 [0.1-1].

Results:

During the long follow-up of twenty years only 3 eyes of 3 different patients (28.5%) required surgical treatment. In two of these eyes, (LPKSP) lamellar peripheral kerato-sclero-plasty was performed by the same surgeon. Resection of a pseudopterygium that covered the visual axis was required in the third patient. One of the patients presented important progression of the corneal disorder after LPKSP surgery. The patient who was affected of pseudopterygium presented slow recurrence during the following 12 years after surgery. One of the patients in the serial (14.2%) complained with a unilateral nodular episcleritis. There have been noticed minimum changes in corneal astigmatism in most patients (71.4%) during the follow-up, but no complications or several visual loss have been observed. The mean BCVA at the end of the follow-up was maintained in 0.86 [0.4-1].

Conclusions:

TMD is a bilateral, asymmetric, slow progressive corneal disorder that origins a peripheral corneal thinning leading to a progressive astigmatism in patients affected. In some cases, extreme thinning threat to corneal perforation. Sometimes TMD can produce pseudopterygium, as a different type of clinical presentation. Based in our experience, most patients preserve a great BCVA after a long-term follow-up with minimum changes in corneal astigmatism. We do agree that in cases with high risk of corneal perforation LPKSP is a reasonable surgical option. FINANCIAL INTEREST: NONE

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