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A combined approach to pellucid marginal degeneration management

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First Author: D.Nevrov RUSSIA

Co Author(s):    Y. Kalinnikov   S. Kalinnikova   -. -              

Abstract Details

Purpose:

To evaluate the efficacy of a combined approach to the treatment of pellucid marginal degeneration

Setting:

Federal State Institution Clinical hospital of the presidential administration of the Russian Federation, Moscow, Russia

Methods:

Analysis of the functional and structural results of a new surgical technique that combines intrastromal lamellar keratoplasty with the use of refractive lenticules obtained from donor patients during the myopic SMILE procedure and simultaneous intracorneal ring segment implantation, followed by a local cross-linking after three months postoperatively in contact lens intolerant patients suffering from visual deterioration due to a high irregular astigmatism, who were diagnosed with pellucid marginal degeneration.

Results:

In the 6 to 9 months postoperative period, the UCVA had improved from 0.1±0.07 to 0.34±0.28 and the BCVA from 0.6±0.26 to 0.7±0.24 (decimal). The corneal thickness increased from 510±32.0 μm to 625±35.0 μm in the zone of the thinning. The corneal topography demonstrated a decrease in maximum simulated keratometry values from 49.15±2.45D to 46.25±2.15D and an astigmatism reduction from 7.2±3.8D to 2.0±0.18D.

Conclusions:

Despite the lack of long-term observation, the new technique proved successful for a number of patients. The ICRS implantation allowed for a significant cylinder reduction and improvement of visual acuity. The lamellar keratoplasty allowed for a reinforcement of the thinned cornea while preserving the patient’s endothelial layer and preventing a graft rejection. The subsequent local collagen cross-linking ensured corneal stability.

Financial Disclosure:

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