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pellucid marginal degeneration

David E Andrus, Jared T Haynes, Steven T Wright
BACKGROUND: Current U.S. Air Force medical standards allow applicants to enter pilot training with up to 1.50 D of astigmatism. However, waivers are considered for individuals with up to 3.00 D of astigmatism. Although typically a benign finding, higher levels of astigmatism may be progressive and can be associated with corneal ectasia (e.g., keratoconus or pellucid marginal degeneration) leading to reduced visual acuity with spectacles and/or soft contact lenses. The goal of this study was to evaluate the long-term outcomes of pilot applicants waivered into training with astigmatism exceeding the aeromedical standard...
March 2017: Military Medicine
Saeed Al-Motowa, Mosa Al-Harby
A 40-year-old male presented with bilateral ectasia, contact lens intolerance, and astigmatism >10 D in both eyes. The patient had end-stage pellucid marginal degeneration that warranted surgical treatment. We present a unique surgical technique to stabilize the cornea, minimize astigmatism, improve vision and corneal status, and avoid penetrating keratoplasty.
October 2016: Middle East African Journal of Ophthalmology
K Balparda, M J Maldonado
OBJECTIVE: To perform a literature review of the current clinical applications of corneal collagen cross-linking. METHODS: An exhaustive literature search was made, including the main biomedical databases, and encompassing all years since the introduction of cross-linking in ophthalmology practice. RESULTS: Corneal collagen cross-linking using UVA irradiation and riboflavin is a surgical technique that is currently being optimised, and is supported by a good amount of pre-clinical and clinical studies...
April 2017: Archivos de la Sociedad Española de Oftalmología
Leyla Asena, Dilek Dursun Altınörs
PURPOSE: To report the clinical outcomes of scleral Misa(®) lenses (Microlens Contactlens Technolgy, Arnhem, Netherlands) for visual rehabilitation in patients with pellucid marginal degeneration (PMD). MEHODS: In this prospective interventional case series, 24 eyes of 12 PMD patients were fitted with scleral Misa(®) lenses. Patients were followed regularly for continuous daily wearing time (CDWT), contact lens handling issues, visual acuity, and any subjective or objective contact lens related complications...
December 2016: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
Jun Shimazaki, Naoyuki Maeda, Osamu Hieda, Yuichi Ohashi, Akira Murakami, Kohji Nishida, Kazuo Tsubota
PURPOSE: A national survey was conducted in Japan to analyze the clinical characteristics of pellucid marginal corneal degeneration (PMD). METHODS: A questionnaire was sent to all members of the Japan Cornea Society requesting demographic and clinical findings on PMD patients who had been examined between 2008 and 2010. The presence of band-shaped peripheral corneal thinning, detected by slit-lamp biomicroscopy or by a pachymetric map, was set as the diagnostic criterion of PMD...
September 2016: Japanese Journal of Ophthalmology
C J Rapuano
Iatrogenic corneal ectasia is a rare but devastating complication after refractive surgery. While its incidence appears to be declining, it has not been eliminated. Its cause is probably related to a combination of an intrinsic predisposition to ectasia and an additional anatomical destabilising effect from the refractive surgery. Determining which eyes are intrinsically "weak" and exactly how much additional "weakening" an eye can withstand before developing progressive thinning and protrusion are both difficult tasks...
June 2016: Klinische Monatsblätter Für Augenheilkunde
Karl Mercieca, Aruna Dharmasena, Charles Hopley
An observational case report of corneal perforation following scleral indentation in a patient with previously undiagnosed pellucid marginal degeneration is presented. Clinical examination, investigations, and subsequent management of this unwarranted and rare complication are described and discussed. The case highlights the need for thorough anterior segment examination before indirect ophthalmoscopy particularly in the presence of ectatic corneal pathology in which case scleral indentation should be avoided...
March 2016: Indian Journal of Ophthalmology
Dorottya Pásztor, Bence Lajos Kolozsvári, Adrienne Csutak, András Berta, Ziad Hassan, Bernadett Ujhelyi, Péter Gogolák, Mariann Fodor
PURPOSE: To compare the concentrations of 11 tear mediators in order to reveal the biochemical difference between pellucid marginal degeneration (PMD) and keratoconus (KC). METHODS: We have designed a cross-sectional study in which patients with corneal ectasia based on slit-lamp biomicroscopy and Pentacam HR (keratometry values (K1, K2, Kmax), astigmatism, minimal radius of curvature (Rmin), corneal thickness (Apex and Min), indices (surface variation, vertical asymmetry, keratoconus, central keratoconus, height asymmetry and decentration)) were enrolled...
2016: PloS One
Damien Guindolet, Alexandra Petrovic, Serge Doan, Isabelle Cochereau, Eric E Gabison
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...
June 2016: Cornea
Janine Lenk, Michael Haustein, Naim Terai, Eberhard Spoerl, Frederik Raiskup
PURPOSE: This study sought to investigate the diagnostic capacity of corneal biomechanical response parameters in a group of patients with pellucid marginal degeneration (PMD) using the Ocular Response Analyzer (ORA) and Corvis ST devices. METHODS: In this prospective clinical study, we used the Corvis ST and ORA devices to investigate the ocular biomechanics of patients with PMD. Eighty-one eyes were included, and 2 study groups were formed: the PMD group (the study group, n = 29) and the control group (n = 52)...
April 2016: Cornea
Rahul A Sharma, Lulu L C D Bursztyn, Elizabeth Golesic, Rookaya Mather, David P Tingey
OBJECTIVE: To compare the effect of Descemet's stripping endothelial keratoplasty (DSEK) with penetrating keratoplasty (PKP) on intraocular pressure (IOP) and use of ocular antihypertensives. DESIGN: Retrospective cohort study. PARTICIPANTS: Thirty-five eyes in 33 patients undergoing PKP and 43 eyes in 38 patients undergoing DSEK were included in the analysis. Fifteen eyes undergoing PKP and 12 undergoing DSEK had diagnosed glaucoma. Patients undergoing corneal transplant because of trauma, keratoconus, pellucid marginal degeneration, or prior failed transplant were excluded...
February 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Leopoldo Spadea, Giorgia Maraone, Carlo Cagini
PURPOSE: To describe the changes in visual acuity and topographic analysis in a patient affected by advanced pellucid marginal degeneration (PMD). METHODS: A 59-year-old woman with bilateral PMD who was contact lens intolerant was treated by sliding keratoplasty before and 3 months after transepithelial (epi-on) iontophoresis collagen cross-linking (I-CXL) in one eye. Corrected distance visual acuity (CDVA), spherical equivalent and cylinder refraction, corneal topography, ultrasound pachymetry, and endothelial cell count were assessed at baseline and up to 12 months postoperatively...
January 2016: Journal of Refractive Surgery
Varsha M Rathi, Preeji S Mandathara, Mukesh Taneja, Srikanth Dumpati, Virender S Sangwan
Scleral lenses are large diameter lenses which rest over the sclera, unlike the conventional contact lenses which rest on the cornea. These lenses are fitted to not touch the cornea and there is a space created between the cornea and the lens. These lenses are inserted in the eyes after filling with sterile isotonic fluid. Generally, scleral contact lenses are used for high irregular astigmatism as seen in various corneal ectatic diseases such as keratoconus, pellucid marginal degeneration, or/and as liquid bandage in ocular surface disorders...
2015: Clinical Ophthalmology
Prafulla K Maharana, Aditi Dubey, Vishal Jhanji, Namrata Sharma, Sujata Das, Rasik B Vajpayee
Corneal ectasias include a group of disorders characterised by progressive thinning, bulging and distortion of the cornea. Keratoconus is the most common disease in this group. Other manifestations include pellucid marginal degeneration, Terrien's marginal degeneration, keratoglobus and ectasias following surgery. Advanced ectasias usually present with loss of vision due to high irregular astigmatism. Management of these disorders is difficult due to the peripheral location of ectasia and associated severe corneal thinning...
January 2016: British Journal of Ophthalmology
Vipul Bhandari, Sri Ganesh
PURPOSE: To report an unusual presentation of pellucid marginal degeneration (PMD) and its management by using air injection and tension sutures. CASE REPORT: We report 2 cases with a history of acute pain and loss of vision. Examination revealed hydrops at the 6-9 o'clock meridian with Descemet's membrane detachment and tear at the same area and advanced PMD in the other eye. DISCUSSION: Air injection with suturing to treat the hydrops in PMD and crescentic excision with lamellar grafting instead of lamellar keratoplasty lead to better results than conservative management...
May 2015: Case Reports in Ophthalmology
Serife Bayraktar, Zafer Cebeci, Merih Oray, Nilufer Alparslan
Purpose. To report the long-term results of corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A irradiation in 4 eyes of 2 patients affected by pellucid marginal degeneration (PMD). Methods. This study involved the retrospective analysis of 4 eyes of 2 patients with PMD that underwent CXL treatment. Of the eyes, three had only CXL treatment and one had CXL treatment after an intrastromal corneal ring segment implantation. We have pre- and postoperatively evaluated uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCDVA), corneal topography (Pentacam), specular microscopy, and pachymetry...
2015: Case Reports in Ophthalmological Medicine
Miltiadis Fiorentzis, Berthold Seitz, Arne Viestenz
PURPOSE: To report a rare case of traumatic wound dehiscence caused by the use of a continuous positive airway pressure (CPAP) mask in a patient with chronic obstructive pulmonary disease (COPD) after penetrating keratoplasty (PKP). METHODS: Observational case report. CASE REPORT: A 55-year-old man who was treated with uncomplicated PKP due to pellucid marginal corneal degeneration in the right eye 9 months earlier presented to the emergency department after a globe rupture caused by dislocation of his CPAP mask during sleep...
June 2015: Cornea
Adel Alhayek, Pei-Rong Lu
Keratoconus is a condition characterized by biomechanical instability of the cornea, presenting in a progressive, asymmetric and bilateral way. Corneal collagen crosslinking (CXL) with riboflavin and Ultraviolet-A (UVA) is a new technique of corneal tissue strengthening that combines the use of riboflavin as a photo sensitizer and UVA irradiation. Studies showed that CXL was effective in halting the progression of keratoconus over a period of up to four years. The published studies also revealed a reduction of max K readings by more than 2 D, while the postoperative spherical equivalent (SEQ) was reduced by an average of more than 1 D and refractive cylinder decreased by about 1 D...
2015: International Journal of Ophthalmology
M Jabbarvand, H Hashemian, M Khodaparast, F Bazvand, A Beheshtnejad
PURPOSE: To evaluate the effect of complete intrastromal corneal ring implantations on patients with pellucid marginal degeneration (PMD). DESIGN: Prospective interventional case series. PATIENTS AND METHODS: Thirty-three eyes with PMD were included into the study. After pocket creation with femtosecond laser (Femtec; 20/10 PerfectVision), MyoRing implantation was performed. Uncorrected and corrected distance visual acuity (UDVA, CDVA), subjective refraction, keratometry, central corneal thickness, corneal biomechanical profile (Ocular Response Analysis), and whole-eye wavefront aberrometry (iTrace) were evaluated preoperatively and also postoperatively, 1 month, 3 months, 6 months, and 1 year after the operation...
June 2015: Eye
A Balestrazzi, S Baiocchi, A Balestrazzi, G Cartocci, G M Tosi, G Martone, P Michieletto
PURPOSE: To evaluate the clinical outcomes, safety, and efficacy of cataract surgery with the implantation of a toric intraocular lens (IOL) in eyes with stable pellucid marginal degeneration (PMD). METHODS: Eleven eyes (eight patients) diagnosed as stable PMD and cataract underwent mini-incision 2.2 mm cataract surgery followed by the implantation of hydrophobic toric aspheric IOL (AcrySof IQ Toric IOL, Alcon, Fort Worth, TX, USA). Perioperative variables of interest included uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, and corneal topography...
May 2015: Eye
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