“Combined Wedge Resection, Collagen Cross Linking And Intrastromal Corneal Rings For Pellucid Marginal Degeneration”

Published 2022 - 40th Congress of the ESCRS

Reference: PO304 | Type: Free paper | DOI: 10.82333/5xfh-xa86

Authors: María de las Mercedes Valentín-Pastrana Aguilar* ¹ , Alejandra González Almazán ¹ , Claudia Azpitarte Sánchez-Muros ¹ , Nicolás Alejandre Alba ²

¹Fundacion Jimenez Diaz University Hospital,Madrid,Spain, ²Cornea Department,Fundacion Jimenez Diaz University Hospital,Madrid,Spain

Purpose

To describe the clinical results of corneal lamellar wedge resection in combination with collagen cross-linking (CXL) and intrastromal corneal rings implantation (ISCR) to correct pellucid marginal degeneration (PMD) in a 59-year-old male patient.

Setting

Anterior Segment Section, Ophthalmology Department, Fundación Jimenez Diaz University Hospital, Madrid (Spain).

Methods

In-depth study of our patient: uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refraction, keratometry, corneal topography, and anterior segment optical coherence tomography.

Results

A 59-year-old male was referred to the anterior segment section for deterioration of BCVA (0.4). Increasing astigmatism was diagnosed with PMD based on clinical exploration and corneal topography. Two months after a lamellar wedge resection was performed, the corneal ectasia regressed. A CXL procedure was carried out to stabilize the progression. Six months later, the diagnostic tests showed corneal irregularities, which consequently lead to an ISCR implantation. The patient's follow-up showed a 0.5 BCVA and a stable topography.

Conclusions

Lamellar wedge resection allows to dissect enough tissue without generating posterior corneal folds and allows a good visual rehabilitation without tissue rejection. This technique combined with lamellar cross-linking and ISCR implantation in cases of advanced PMD could stabilize topographical and refractive results and reduce the risk of regression.