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CHRISTIAN DENISSE PINKUS HERRERA, Enrique O Graue-Hernandez, Arturo J Ramirez-Miranda, Mariana Lucila Urdapilleta, Alejandro Navas; Long-term follow-up of Corneal Collagen Crosslinking for Pellucid Marginal Degeneration. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3505.
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© ARVO (1962-2015); The Authors (2016-present)
Pellucid marginal degeneration (PMD) is a rare ectatic disorder with steepening and thinning in the peripheral cornea which may also, as keratoconus, benefit from corneal collagen crosslinking (CXL). This entity has been evaluated much less than keratoconus especially with regard to CXL treatment.We performed a retrospective, observational clinical study to learn about the clinical and topographic changes after CXL in PMD, and to determine safety and effectiveness of this treatment option to prevent disease progression.
Clinical charts from year 2008 to 2016 of subjects diagnosed with PMD who were treated with CXL were reviewed. Nineteen eyes of 13 patients (8 women) were included, mean age was 33.78 years (range 14 to 46). Visual acuity (VA), mean keratometries (KM), corneal astigmatism, intraocular pressure (IOP), spherical equivalent (SE) and pachymetry were compared preoperatively and postoperatively with a mean follow-up of 13.89 months (range 3 to 24 months). Paired t test and STATA 8.0 were used for statistical analysis.
No statistical significant differences were found in mean keratometries from 47.71 ±3.72 to 47.51 ± 4.07 diopters (p=0.544), corneal astigmatism from 4.2 ± 2.49 to 4.23 ± 2.03 diopters (p=0.995), IOP from 13.66 ± 1.58 to 12.77 ±1.85 mmHg(p=0.175), SE from -9.53 ±7.67 to -4.82 ±3.64 diopters(p=0.141) and pachymetry from 425.68 ± 24.51 to 434.43 ±27.36 microns (p=0.107).Statistical significant differences were found in visual acuity from 0.44 ± 0.40 to 0.25 ± 0.26 logMAR (p=0.007).None of the subjects presented any complication related or not to the procedure.
This is a large study with long-term follow-up of subjects with PMD treated with crosslinking. Corneal collagen crosslinking in progressive PMD is a safe and effective long-term treatment for avoiding ectasia progression and also improves visual acuity, hence avoiding other invasive surgical treatments such as corneal transplantation when treated early.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Curvature map of a right eye of a 37-year-old-woman before crosslinking.
Curvature map of a right eye of the same woman 12 months after crosslinking treatment.
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