Case Report: Long-Term Follow-up of Corneal Collagen Crosslinking in Pellucid Marginal Degeneration

In this case report, a 46-year-old man with bilateral pellucid marginal degeneration (PMD) corrected distance visual acuity (CDVA) of 20/20 (-2.00×80) in the right eye (OD) and 20/30 (+3.50-5.25×105) in the left eye underwent conventional 9 mm eccentric corneal collagen crosslinking (CXL) in both eye and intrastromal corneal ring implantation in both eyes.

PMD is a corneal thinning disorder that is often confused with keratoconus. Both can be treated with CXL. At 1-year follow-up there was stabilization of the ectasia, however, progressive inferior flattening was observed with decreased CDVA, corneal thinning and worsening of the haze in the following years.

In the patients final follow-up visit, his CDVA was 20/40 (+5.00-2.00×55) OD and 20/60 (+6.00-1.50×80) in both eyes.

The authors hope that this report brings to light the idea “that mid- and long-term evaluations of customized crosslinking techniques may reveal progressive flattening and corneal irregularity.”

Reference

Gabriel de Almeida Ferreira G, Ghanem VC, Ghanem RC. Late progressive corneal flattening, haze and visual loss after eccentric crosslinking for pellucid marginal degeneration. Am J Ophthalmol Case Rep. 2020;18, 100621. eCollection: DOI: 10.1016/j.ajoc.2020.100621