Combined wedge resection and beveled penetrating relaxing incisions for the treatment of pellucid marginal corneal degeneration

Cornea. 2008 Jun;27(5):595-600. doi: 10.1097/ICO.0b013e318166c40c.


Purpose: To evaluate a new surgical approach for the treatment of pellucid marginal corneal degeneration (PMCD).

Methods: Prospective, noncomparative, interventional case series. Ten eyes of 10 consecutive patients were included in the series. Inclusion criteria were a clinical diagnosis of PMCD, topographic astigmatism >10 D, and contact lens intolerance. The patients underwent an inferior arcuate wedge resection of the thinned cornea (0.5 mm wide, 6.0 mm long) combined with 2 penetrating, sutureless, clear corneal tunnel relaxing incisions (3.2 mm wide) at the steep meridians.

Results: Visual acuity, refraction, and corneal topography were assessed preoperatively and at 1, 3, 6, 12, and 24 months postoperatively. Suture removal was complete in all patients by 4 months. Spectacle-corrected visual acuity was 20/40 or better in 8 of 10 patients at 6 months, with no substantial change at later examinations. Mean keratometric astigmatism was reduced from 15.1 D preoperatively to 4.6 D at 6 months postoperatively and was stable at further follow-ups.

Conclusions: Corneal wedge resection combined with paired, opposed clear corneal penetrating relaxing incisions is a suitable surgical option for the treatment of PMCD, providing early adequate astigmatic control with long-term stability.

MeSH terms

  • Adult
  • Aged
  • Astigmatism / physiopathology
  • Astigmatism / prevention & control
  • Corneal Dystrophies, Hereditary / physiopathology
  • Corneal Dystrophies, Hereditary / surgery*
  • Corneal Topography
  • Corneal Transplantation / methods*
  • Female
  • Humans
  • Keratoplasty, Penetrating / methods
  • Male
  • Middle Aged
  • Prospective Studies
  • Refraction, Ocular / physiology
  • Suture Techniques
  • Visual Acuity / physiology