Conservative Treatment of Early and Moderate Pellucid Marginal DegenerationA new refractive approach with intracorneal rings

Comparing Nomograms of Two Symmetric and Two Asymmetric Intacs(r) Segments Implantation for Treatment of Pellucid Marginal Degeneration

“…Pellucid marginal degeneration (PMD) is a disease with a complicated prognosis in patients who are intolerant to contact lenses (10). Different procedures have been used to treat PMD with unpredictable results.…”

“…In the early stages, spectacles and contact lenses are the usual treatment approaches; however, in patients who cannot be rehabilitated with these options, a surgical procedure is necessary (10). Different surgical options include crescentic wedge resection, crescentic lamellar keratoplasty, penetrating keratoplasty, epikeratophakia and thermokeratoplasty.…”

“…However, all these techniques have disadvantages: unpredictability, irreversibility, long period of rehabilitation and significant complication rates (11)(12)(13)(14)(15)(16). Authors suggest the use of intracorneal rings (ICR) in glasses/contact lens-intolerant patients affected by early and moderate PMD with against-the-rule astigmatism and inferior peripheral corneal thickness of >450 µm (10). Since ICR mechanically lifts the inferior ectasia of PMD, flattens the soft ectatic corneal tissue, and decreases asymmetrical astigmatism, visual acuity is expected to improve following this procedure (17).…”

“…Various reports have been published illustrating either the symmetrical (inserting two same-size segments) or the asymmetrical (inserting two different size segments) Intacs® implantation techniques for the management of PMD. Both these techniques have been independently shown to improve UCVA, BSCVA and topographic findings (9,10).…”

Treatment of Pellucid Marginal Degeneration

“…[25][26][27][28][29][30][31] A case report showed improvement of visual acuity after femtosecond implantation of a single ICRS in superior PMD. However, follow-up was only for 3 months.…”