Femtosecond Laser Assisted Lamellar Horseshoe Sclerokeratoplasty In Terrien Marginal Degeneration: A Case Report

To report a case of Terrien marginal degeneration managed with lamellar horseshoe sclerokeratoplasty.

Terrien marginal degeneration is an uncommon disease that results in corneal peripheral thinning. Surgical treatment is indicated when astigmatism significantly limits visual acuity or when perforation risk in high secondary to corneal thinning.

A nineteen years old male with Terrien marginal degeneration in left eye in follow up with best corrected visual acuity 20/25 presents progressive corneal thinning (145 um thinnest) and increase astigmatism. femtosecond laser assisted  lamellar horseshoe sclerokeratoplasty was performed.

The Donor and Receptor corneas were marked with Femtosecond laser before stromal dissection. 2 millimeters of sclera was also dissected.  In the third post-operative week, transplant presents slightly opacification which was managed with Increase in Topical corticosteroids frequency.  In the fourth post-operative month, the best corrected visual acuity was 20/50 without further post-operative complications.

Lamellar horseshoe sclerokeratoplasty is a therapeutic option in the management of severe peripheric corneal degenerations. Femtosecond laser can be a useful tool to get the graft and to make the recipient marking ,thus achieving a more exact fit.