Abstract:
PURPOSE:Surgical management of advanced pellucid marginal degeneration is challenging. To correct both corneal thinning and induced corneal astigmatism, we propose a modified intrastromal lamellar sclero-keratoplasty. METHODS:Corneal thinning was mapped using perioperative optical coherence tomography (OCT). Then through a scleral tunnel, an intrastromal pocket was created by stromal lamellar dissection under OCT guidance. A 300 μm-thick stromal lamellar graft was inserted in that pocket before closing the sclera to increase vertical median keratometry. RESULTS:Intrastromal lamellar sclero-keratoplasty enabled corneal thinning correction and increased corneal astigmatism correction (-11.6 diopters) without complications. CONCLUSIONS:Intrastromal lamellar keratoplasty with scleral tunnel is efficient in PMD. Corneal thinning is corrected with the intrastromal lamellar keratoplasty, and scleral tunnel closure allows increased corneal astigmatism correction. Perioperative OCT guidance allows better detection of the diseased cornea and is helpful for the lamellar dissection.
journal_name
Corneajournal_title
Corneaauthors
Guindolet D,Petrovic A,Doan S,Cochereau I,Gabison EEdoi
10.1097/ICO.0000000000000813subject
Has Abstractpub_date
2016-06-01 00:00:00pages
900-3issue
6eissn
0277-3740issn
1536-4798journal_volume
35pub_type
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