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February 1993

Pellucid Marginal Degeneration Treated by Lamellar and Penetrating Keratoplasty

Author Affiliations

Petah Tiqva, Israel; Philadelphia, Pa

Arch Ophthalmol. 1993;111(2):169-170. doi:10.1001/archopht.1993.01090020023013

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Pellucid marginal degeneration (PMD) is characterized by noninflammatory, inferior peripheral corneal thinning, progressing to a narrow band (1 to 2 mm) of corneal ectasia 1 to 2 mm above the inferior corneal limbus.1 The degree of thinning is usually severe, resulting in up to 80% stromal loss, but the overlying corneal epithelium remains intact. The final condition consists of corneal topographic abnormalities characterized by a flattened vertical meridian.1 The inferior corneal ectasia may be so steep as to offset the central vertical flattening, resulting in a paradoxical "with-the-rule" astigmatism.1 A number of surgical procedures for visual rehabilitation of patients with PMD have been described. These include thermocauterization, total lamellar keratoplasty, crescentic lamellar keratoplasty, eccentric penetrating keratoplasty,1 crescentic resection,2 and even crescentic penetrating keratoplasty.3

Report of a Case.  —A 37-year-old woman with a diagnosis of bilateral keratoconus, more advanced in her left eye, has been

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