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Management of pellucid marginal corneal degeneration with simultaneous photorefractive keratectomy and collagen cross-linking

Poster Details

First Author: V.Virijevic SERBIA

Co Author(s):    V. Suvajac   K. Savic   M. Vujanic   B. Djurovic           

Abstract Details


To present a case of simultaneous photorefractive keratectomy (PRK) and collagen crosslinking (CXL) in patient with progressive pellucid marginal degeneration (PCD)


Eye clinic �â�€�žProfesional - Dr Suvajac�â�€�œ, Belgrade, Serbia


Case report of a thirty-year-old patient who was admitted because of visual impairment, more pronounced in the left eye (LE). Uncorrected visual acuity (UCVA) in the right eye (RE) was 20/80, LE 20/200. Best corrected visual acuity (BCVA) RE was 20/20 with -1,0/-1,75x95, LE 20/25 with �,0/-6,0x90. Patient was contact lens intolerant. Corneal tomography showed mild against-the-rule astigmatism in the RE and in the LE classic �â�€�œkissing birds�â�€� pattern of PMD, high against-the-rule astigmatism and clear signs of progression compared with previous exams. AS-OCT LE showed stromal thinning and epithelial hyperplasia in the region of maximal stromal thinning.


LE was treated with simultaneous PRK and standard Dresden protocol CXL. Epithelium was removed with Amoils brush then PRK was performed (Wavelight Allegretto EyeQ 400Hz), -4,0x90 was removed at OZ 5,5mm with intended total ablation depth of 40microns. Then standard Dresden protocol CXL with isotonic riboflavin 0.1% solution was performed. After the treatment, a bandage contact lens was applied until reepithelialization occurred. One month postoperatively UCVA was 20/40. At the 6-month examination UCVA was more than 20/30, BCVA close to 20/25 with -2,0x100. Cornea was clear and tomography showed less irregular anterior corneal surface, AS-OCT showed more regular epithelium.


Simultaneous PRK and standard Dresden protocol CXL is effective option for progressive PCD and contact lens intolerant patients. Despite the encouraging results, longer follow-up is necessary to confirm the stability of the results.

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