![]() Sutures were selectively adjusted and tightened unequally to address preexisting astigmatism. The cornea was sutured in a manner similar to PKP using 16-interrupted 10–0 nylon sutures. A Hessburg-Barron vacuum trephine (Barron Precision Instruments, Grand Blanc, MI, USA) was used, and the cornea was partially trephined at 8 mm diameter to 90% of the actual corneal thickness. The geometric center of the cornea was marked with a Sinskey Hook and a marking pen. A surgical drape was placed on the eye, and a lid speculum was placed to maximize globe exposure. The eye was prepared in a sterile fashion, and two drops of topical anesthetic were instilled. The right eye underwent surgery first in April 2012. The patient consented to the undergo Motowa's Trephine with Selective Suturing Technique. The risk and benefits of PKP, lamellar keratoplasty, and Motowa's Trephine with Selective Suturing Technique were explained to the patient. This surgical technique is a partial thickness corneal trephination with adjusted compression sutures. The patient was offered a novel surgical technique (Motowa's Trephine with Selective Suturing Technique) that would allow him to retain his cornea rather than undergo corneal transplantation. Corneal topographies were consistent with the patterns characteristic of PMD in both eyes. His best-corrected visual acuity (BCVA) was 20/25 OU with the following refractions: OD, Plano − 11.00 × 90° and OS, +0.25 − 12.00 × 85°. The presenting uncorrected visual acuity (UCVA) was 20/300 in the right eye and 7/200 in the left eye. The patient had undergone bilateral wedge resection, 7 years before presentation. The patient underwent a novel surgical technique to manage high astigmatism and irregularity secondary to PMD, avoiding the need for keratoplasty.Ī 40-year-old male with a document of the history of PMD presented with complaints of decreased vision and extreme discomfort with CL. In this case report, we describe the presentation and surgical management of a patient with PMD. ![]() Some cases of graft rejection have been reported, and long-term use of topical and systemic steroids to mitigate graft rejection is required after lamellar keratoplasty. However, lamellar keratoplasty is a technically challenging procedure. Lamellar keratoplasty mitigates many of the complications of PKP. The disadvantages of PKP include graft rejection and long-term use of topical and systemic steroids. PKP involves the replacement of diseased cornea with a full-thickness donor cornea. Two common surgical treatments for corneal ectasia are lamellar keratoplasty and PKP. A variety of surgical techniques have been described for corneal ectasia, including intracorneal ring segments (ICRSs), full-thickness crescentic wedge resection in PMD, and lamellar keratoplasty, and penetrating keratoplasty (PKP). The topographic pattern often resembles a “lobster-claw.”Īs corneal ectasia progresses, the management changes from optical aids such as spectacles and contact lenses (CLs) to surgical intervention. ![]() PMD is a bilateral ectasia characterized by a peripheral band of thinning that incorporates the inferior quadrant of the cornea, with a central 1–2 mm zone of normal cornea. Keratoconus is the leading indication for corneal transplantation surgery worldwide. Keratoconus and pellucid marginal degeneration (PMD) are noninflammatory progressive ectatic corneal disorders, characterized by thinning of the corneal stroma that often leads to irregular astigmatism and a subsequent decrease in visual acuity. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |