AS-OCT showed a decrease in corneal thickness and DM attachment in the right eye. The BCVA improved to 0.18 logMAR with a correction of -1.0 DS/-2.0 DC*110, N6 in the right eye and 0.1 logMAR with a correction of +1.0 DS/-3.25 DC*60, N6 in the left eye at the end of 6 months after complete suture removal. In the left eye, we performed a lamellar crescentic excision and placed an undersized graft with tight sutures with accelerated collagen cross-linking (C3R) (fig. We performed an air injection with tension sutures to reattach the DM in the right eye. Corneal thickness was 462 μm in the inferior area near the limbus. Orbscan and Pentacam imaging was performed in the left eye. Neither Fleischer ring nor Vogt's striae were noted. In the left eye, the cornea was clear except for a crescent-shaped area of subepithelial scarring approximately 3 mm in length superior to the inferior limbus. Slit-lamp biomicroscopy in the right eye revealed a dense central and nasal corneal edema with DM detachment and tear. Upon presentation, his BCVA was 2.3 logMAR in the right eye and 0.60 logMAR in the left eye. He reported a gradual decrease in vision over the past 10 years. He was in good general health and had no history of systemic disorders, seasonal allergy or recent ocular trauma. 6a, b).Ī 35-year-old man presented with symptoms of pain, photophobia, tearing and severe visual loss in his right eye of 4 days' duration. Orbscan and Pentacam images showed no signs of progression during the follow-up period of 16 months. No complications were noted in the follow-up period. AS-OCT showed a decrease in corneal thickness and DM attachment in the left eye (fig. The BCVA improved to 0.18 logMAR with a correction of -1.0 DS/-2.0 DC*130, N6 with near add of +1.50 D in the left eye and 0.1 logMAR with a correction of +1.0 DS/-3.0 DC*70, N6 with a near add of +1.50 D in the right eye at the end of 6 months after complete suture removal. In the right eye, we performed a lamellar crescentic excision and placed an undersized graft with tight sutures with accelerated collagen cross-linking (C3R). We performed an air injection with tension sutures to reattach the DM in the left eye (fig. Orbscan (Bausch and Lomb, Germany) and Pentacam (Oculus, Germany) imaging was performed in the right eye (fig. In the right eye, the cornea was clear except for a crescent-shaped area of subepithelial scarring approximately 3 mm in length superior to the inferior limbus. Anterior segment optical coherence tomography (AS-OCT) was performed (fig. Slit-lamp biomicroscopy in the left eye revealed a dense central and nasal corneal edema with DM detachment and tear (fig. Upon presentation, his best corrected visual acuity (BCVA) was 1.77 logMAR in the left eye and 0.48 logMAR in the right eye. Case ReportsĪ 48-year-old man presented with symptoms of pain, photophobia, tearing and severe visual loss in his left eye of 4 days' duration. Herein we report an unusual case series of PMD with spontaneous corneal hydrops and describe its management. This is a rare complication of keratoconus and is even rarer in PMD. It is well known to occur in keratoconus and has also been reported in other corneal ectasia, especially in PMD and keratoglobus. Acute hydrops is the development of marked edema of the corneal stroma and epithelium following a break in Descemet's membrane (DM). The various presentations include superior PMD or PMD in association with keratoconus or keratoglobus. Atypical presentations of PMD have been reported in the literature. A characteristic pattern of inferior corneal steepening and subsequent against-the-rule astigmatism is found on corneal topography. A 1- to 2-mm zone of uninvolved normal cornea separates the region of thinning from the peripheral limbus. The hallmark of this disorder includes an area of corneal protrusion above the point of maximal thinning rather than within the area of maximal thinning as with keratoconus. Pellucid marginal degeneration (PMD) is characterized by nonulcerative, noninflammatory, clear thinning of the inferior portion of the peripheral cornea.
0 Comments
Leave a Reply. |