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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

Purpose:

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

Setting:

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

Methods:

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.

Results:

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.

Conclusions:

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.

Financial Disclosure:

NONE

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