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Corneal cross-linking (CXL) in eyes with classic pellucid marginal degeneration (PMD)

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Session Details

Session Title: Cross-Linking II

Session Date/Time: Tuesday 16/09/2014 | 16:30-18:00

Paper Time: 17:48

Venue: Boulevard A

First Author: : G.Schmidinger AUSTRIA

Co Author(s): :    N. Pircher   S. Pieh           

Abstract Details


Classic PMD is a very rare disease which results in para-limbal thinning of the inferior cornea accompanied with corneal ectasia and irregular astigmatism. PMD is often misdiagnosed based on topographic maps of keratoconus cases that mimic classic PMD patterns. This trial was performed to evaluate the effect of CXL in eyes with PMD.


Department of Ophthalmology, Medical University of Vienna, Austria


Out of more than 600 consecutive keratoconus cases which presented at our department, patients with classic PMD were selected. Classic PMD was differentiated from keratoconus cases with PMD-like topography by means of Scheimpflug imaging and slit-lamp evaluation. Progressive cases underwent CXL treatment with eccentric UVA-illumination. Visual acuity with and without correction, topographic parameters and pachymetry readings were recorded.


Out of 620 eyes we could identify 7 cases with classic PMD. All patients with classic PMD were male. Out of these seven cases, six had a progressive disease as documented by repeated evaluation of topography and pachymetry. These six cases were treated with CXL. The uncorrected visual acuity increased from 1.54 logMAR to 1.20 logMAR after 6 months. The corrected visual acuity increased from 0.34 logMAR to 0.28 logMAR. Six months after the treatment the mean K readings decreased by 2.23 diopters. Interestingly, the thinnest appoint of the pachymetry reading increased by 40 ┬Ám. No case with loss of visual acuity or progression of the disease was observed.


Classic PMD is a rare disease with marked gender distribution towards male patients. To date, only two case reports have been published on PMD cases treated with CXL. This trial presents data on a small collective of patients showing that CXL can halt the progression of the disease and stabilize visual acuity. Concerning secondary refractive interventions, a minimum waiting time of 6 months should be observed after CXL treatments.

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