Management of pellucid marginal corneal degeneration

Purpose A retrospective study to ascertain the management of pellucid margi nal corneal degeneration (PMCD). Method and results Sixteen patients (average age 42.6 years) presented with PMCD. PMCD was bilateral in 13 and unilateral in 3 patients. Eight eyes un derwent surgery. Nineteen eyes were managed non-surgically. Surgery involve d corneal wedge excision (WE) (6 eyes), penetrating keratoplasty (PK) (3 ey es) and lamellar thermo-keratoplasty (LTK) (1 eye). Immediate pre-operative average visual. acuity (VA) was 6/24, 6/10 and 6/60 with an average pre-op erative astigmatism of 11.40 D, 9.75 D and 20.5 D for WE, PK and LTK respec tively. After an average post-operative follow-up of 57 months, 66 months a nd 1 year, the average astigmatism was 8.90 D, 4.63 D and 6.00 D with an av erage final VA of 6/19, 6/15 and 6/6 for WE, PK and LTK respectively. In th e nonsurgical group, at presentation, 40% of eyes had a VA of 6/12 or bette r. After an average follow-up period of 32.3 months, 80% of eyes had a visu al acuity of 6/12 or better. Optical correction was achieved with spectacle s and or contact lenses. Conclusions Surgical correction for PMCD provides poor long-term reduction of astigmatism. Patients with PMCD may be adequately corrected in the long term by the use of scleral fitted gas-permeable contact lenses.