Five eyes in four patients with pellucid marginal corneal degeneration were treated by lamellar crescentic resection of the thinned area inferiorly. Normal-thickness stroma was then reapposed to normal-thickness stroma with multiple interrupted 10-0 polypropylene sutures. If excessive central corneal steepening along a vertical meridian was present three months after surgery, selected sutures were cut and removed depending on the slit-lamp appearance, keratometry reading, and photokeratograph pattern. Improvement of visual acuity to 20/40 or better was obtained in four of the five eyes with a follow-up of 27 to 40 months (mean, 31.8 months). Early loosening of sutures resulted in a recurrence of corneal thinning and astigmatism in one eye. Pannus developed inferiorly in all five eyes.