Abstract
A 35 year-old male patient with pellucid marginal corneal degeneration underwent crescentic lamellar excision with autolamellar dissection on his left eye. One month later, the patient developed localized corneal edema overlying the area of the crescentic resection due to Descemet membrane detachment. The Snellen corrected visual acuity reduced from 6/15 one week postoperatively to 2/60 following the development of corneal edema. The fluid that collected in the interface was removed with a blunt 30-gauge cannula, and air was injected into the anterior chamber to oppose the two corneal layers. Corrected visual acuity improved to 6/12 over 1 month, and to 6/9 seven months later. The corneal edema resolved over 2 months. Crescentic lamellar excision with autolamellar dissection could be associated with Descemet membrane detachment and corneal edema; however, this complication has a very good outcome when managed with a minimally invasive procedure.
Highlights
Pellucid Marginal Corneal Degeneration (PMCD) is a progressive, noninflammatory peripheral corneal thinning disorder characterized by a peripheral band of thinning, mostly of the inferior cornea, from the 4-o’clock to the 8-o’clock position accompanied by 1 to 2 mm of normal cornea between the limbus and the area of thinning [1]
This is mainly due to the progression of ATR astigmatism, as in the case of crescentic wedge resection, or due to the inherent suboptimal visual results associated with penetrating keratoplasty [3,4]
The correction of irregular astigmatism caused by a primary corneal ectasia, such as the PMCD, remains a challenge for eye care practitioners
Summary
Pellucid Marginal Corneal Degeneration (PMCD) is a progressive, noninflammatory peripheral corneal thinning disorder characterized by a peripheral band of thinning, mostly of the inferior cornea, from the 4-o’clock to the 8-o’clock position accompanied by 1 to 2 mm of normal cornea between the limbus and the area of thinning [1]. Crescentic lamellar excision with autolamellar dissection could be associated with Descemet membrane detachment and corneal edema; this complication has a very good outcome when managed with a minimally invasive procedure. This is mainly due to the progression of ATR astigmatism, as in the case of crescentic wedge resection, or due to the inherent suboptimal visual results associated with penetrating keratoplasty [3,4].
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