Combined tissue excision and corneal tuck for the surgical treatment of extremely advanced pellucid marginal corneal degeneration

Cornea. 2013 Dec;32(12):1628-30. doi: 10.1097/ICO.0b013e3182a64850.


Pellucid marginal corneal degeneration (PMCD) is managed surgically in the advanced stages of the disease, but extreme thinning extending over a very wide area in most of the corneal circumference represents a true surgical challenge that makes conventional approaches unsuitable. Here, we present the results of a new procedure (partial excision of the corneal ectasia and tuck of the residual thinned corneal lips left behind) performed in 3 eyes of 2 patients with extremely advanced PMCD, judged unsuitable for undergoing conventional surgical approaches. Preoperatively, uncorrected visual acuity was limited to the perception of hand motion in 1 eye, which presented with hydrops, and to finger counting at 1 m in the other 2 eyes. With a follow-up of 3 to 4 years, a complete, stable resolution of the ectasia was seen in all cases. As early as 1 year postoperatively, the best spectacle-corrected visual acuity was 20/30 to 20/50 with no subsequent substantial changes. Partial excision of the ectasia and tucking was found to work successfully at achieving both a new corneal shape compatible with visual rehabilitation and restoring peripheral corneal thickness in advanced cases of PMCD that were unsuitable for conventional surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cornea / pathology
  • Cornea / surgery*
  • Corneal Diseases / surgery*
  • Female
  • Humans
  • Male
  • Ophthalmologic Surgical Procedures / methods
  • Treatment Outcome
  • Visual Acuity