Wedge resection and lamellar dissection for pellucid marginal degeneration

Cornea
Luke J Maccheron, Sheraz M Daya

Abstract

To describe the use of crescentic corneal lamellar wedge resection and autolamellar dissection for the correction of pellucid marginal degeneration (PMD), and to assess its effectiveness in improving uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), astigmatism, corneal topography, and contact lens or spectacle tolerability. The setting was a specialist referral corneal surgery center, United Kingdom. A retrospective review was performed of all patients who underwent a corneal wedge resection for PMD at our institutions. All patients had progressive deterioration of BCVA, increased astigmatism, and intolerance to contact lens wear. The irregular corneal shape with ectasia was detected clinically and confirmed by Orbscan tomography. A crescentic wedge of ectatic corneal tissue was excised in each case, the extent of which was judged both clinically and by Orbscan. Complete host deep lamellar dissection (limbus to limbus) was performed in 3 cases and partial host lamellar dissection in 3 cases to enable closure by mobilizing the host anterior lamellar cornea. Mersilene 10-0 (Ethicon, Somerville, NJ) sutures were used and adjusted to achieve a 90-degree shift in the axis of astigmatism. Seven eyes of 6 patient...Continue Reading

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Citations

Aug 22, 2015·The British Journal of Ophthalmology·Prafulla K MaharanaRasik B Vajpayee
May 13, 2014·Journal of Refractive Surgery·Majid MoshirfarSteven M Christiansen
Dec 21, 2019·Indian Journal of Ophthalmology·Rashmi DeshmukhRasik Vajpayee

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