Conservative treatment of early and moderate pellucid marginal degeneration: a new refractive approach with intracorneal rings.

Abstract

To evaluate the use of the intracorneal ring (ICR; Intacs, Addition Technology, Inc., Fremont, CA) for the treatment of pellucid marginal degeneration (PMD). Case series. Eight patients with PMD who were intolerant to contact lenses received ICR segments in the superior cornea (0.25 mm thickness) and in the inferior cornea (0.45 mm thickness). The diagnosis was supported by Orbscan II tomography (Bausch & Lomb). Preoperative and postoperative uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), refractive astigmatism, and spherical equivalent were assessed. Changes in corneal shape were evaluated by corneal tomographic maps. The minimum follow-up was 12 months (range, 12-42 months; standard deviation [SD], 14.14). Uncorrected visual acuity improved in all 8 eyes (100%). At the last postoperative examination, 6 eyes (75%) had a BCVA > or =20/25; mean postoperative refractive astigmatism was -2.53 (range, -4.50 to -1.25; SD, 1.03). Mean postoperative spherical equivalent was -1.52 (range, -7.25 to +1.87; SD, 3.01). At the third postoperative month, refractive stability was obtained. No patients lost any Snellen lines of BCVA. No intraoperative and postoperative complications occurred. Intracorneal ring implantation is a promising new treatment for patients with early to moderate PMD and who are intolerant of contact lenses.