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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five eyes in four patients with pellucid marginal corneal degeneration were treated by lamellar crescentic resection of the thinned area inferiorly. Normal-thickness stroma was then reapposed to normal-thickness stroma with multiple interrupted 10-0 polypropylene sutures. If excessive central corneal steepening along a vertical meridian was present three months after surgery, selected sutures were cut and removed depending on the slit-lamp appearance, keratometry reading, and photokeratograph pattern. Improvement of visual acuity to 20/40 or better was obtained in four of the five eyes with a follow-up of 27 to 40 months (mean, 31.8 months). Early loosening of sutures resulted in a recurrence of corneal thinning and astigmatism in one eye. Pannus developed inferiorly in all five eyes.
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PMID:Results of lamellar crescentic resection for pellucid marginal corneal degeneration. 154 23

Freehand corneoscleral lamellar grafts were used in the treatment of advanced Terrien's marginal degeneration of the cornea in four eyes of three patients followed over a period of 12 to 20 years. Anatomic reconstruction of the ectatic thinned peripheral cornea was achieved and irregular astigmatism eliminated in all four eyes. Corneal astigmatism secondary to the corneal ectasia was reduced by 4.00 to 9.00 diopters. The progressive increase in against-the-rule astigmatism associated with advancing Terrien's was arrested for up to 20 years. Gradual thinning of the lamellar graft was noted in all four eyes after 10 years, but the return of corneal ectasia and increasing astigmatism has not occurred.
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PMID:Corneoscleral freehand lamellar keratoplasty in Terrien's marginal degeneration of the cornea--long-term results. 204 40

Computer-assisted corneal topographic analysis was used to evaluate the corneal contour of four patients with Terrien's marginal degeneration. The corneal topography in these patients was characterized by flattening over the areas of peripheral thinning produced by the disorder. When thinning was restricted to the superior and/or inferior areas of the peripheral cornea, there was a relative steepening of the corneal surface approximately 90 degrees away from the midpoint of the thinned area. This resulted in high against-the-rule or oblique astigmatism characteristic of the disorder. This common pattern is attributable to the frequency with which the superior and/or inferior peripheral cornea is preferentially involved in Terrien's marginal degeneration. In some patients, the central corneal topography may remain relatively spherical if the area of thinning is small or if the disorder extends around the entire circumference of the cornea.
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PMID:Terrien's marginal degeneration: corneal topography. 224 99

Over a 14-year period from 1974 to 1988, 12 eyes of 11 patients with pellucid marginal corneal degeneration underwent penetrating keratoplasty. Peripheral corneal thinning required a large eccentric graft in each case. Follow-up ranged from one to eight years (mean, three years). One graft failed because of a persistent epithelial defect with keratolysis of the wound. Although endothelial allograft rejection was common, occurring in seven of 11 (64%) clear grafts, no graft failed because of rejection. Other complications included retinal detachment and a bacterial corneal ulcer. Suture erosion and vascularization of the graft were not problems. Postoperative spectacle correction was dispensed an average of 11 months after surgery. Visual acuity in seven patients without amblyopia, retinal disease, or a previous corneal ulcer at the time of spectacle correction ranged from 20/20 to 20/40 (mean, 20/30). Average final keratometric astigmatism in these patients was 2.46 diopters (range, 0.00 to 5.25 diopters). We believe that penetrating keratoplasty offers an excellent surgical result for patients with pellucid marginal corneal degeneration.
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PMID:The results of penetrating keratoplasty for pellucid marginal corneal degeneration. 237 79

Terrien's disease is characterized by slowly progressive thinning of the pre-limbal cornea in middle-aged patients. It usually leads to peripheral ectasia with marked astigmatism. It is rarely accompagnied by inflammation and its cause is unknown. Very few histopathologic examinations have been published, in particular those using electron microscopy We present detailed results concerning 6 patients in whom perforating keratoplasty permitted histopathologic and electron microscopic examination. Clinical and histological features reveal marked degeneration of the peripheral corneal stroma, with lipid accumulation unaccompagnied by significant inflammatory cellular infiltration in each case. Of interest is the association in one patient with keratoconus. The generally accepted pathogenic theories are fully discussed. The wealth of electron microscopic data provides a complete review of stromal degenerative changes.
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PMID:[Terrien's disease, apropos of 6 cases. Ultrastructural study]. 248 56

Terrien's disease occurs in middle-aged patients and is characterised by an insidious thinning of the cornea near the limbus. In most cases, this results in a peripheral ectasia associated with a severe degree of astigmatism. Inflammatory signs are rarely observed in this marginal corneal degeneration which is of unknown aetiology. Electron and light microscopic studies have been performed on five specimens from penetrating keratoplasties. Anatomical and clinical correlations showed the marked marginal degenerations of the corneal stroma to be consistently associated with lipid deposits, but without inflammatory cell infiltrate. These changes are in agreement with previous reported pathological descriptions of Terrien's disease.
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PMID:Terrien's disease: clinical and ultrastructural studies, five case reports. 263 Mar 64

Keratoconus and other noninflammatory corneal thinning disorders (keratoglobus, pellucid marginal degeneration and posterior keratoconus) are characterized by progressive corneal thinning, protrusion and scarring; the result is distorted and decreased vision. The etiology and pathogenesis of these disorders are unknown but may be associated with a variety of factors, including contact lens wear, eye rubbing, Down's syndrome, atopic disease, connective tissue disease, tapetoretinal degeneration and inheritance. Recent advances in techniques for biochemical and pathological investigation are now allowing further exploration in these areas. Early diagnosis is aided by the finding of irregular corneal astigmatism with inferior corneal steepening. Treatment ranges from simple spectacle correction to keratoplasty. In this review, the past and present literature on corneal thinning disorders is reviewed and practical approaches to diagnosis and management are outlined.
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PMID:Keratoconus and related noninflammatory corneal thinning disorders. 623 Jul 45

Human donor corneas were used for penetrating keratoplasty in one eye of each of 12 rhesus monkeys. In six animals, a 9.5-mm cornea was sutured into a 9.0-mm recipient bed by means of interrupted 10-0 nylon sutures. Six other animals received a 6.5-mm cornea in a 6.0-mm bed. Biomicroscopy, pachymetry, and specular microscopy revealed two distinct healing patterns. Of the six eyes receiving the smaller grafts, five showed prompt, stable clearing and thinning of the grafts with endothelial cell densities ranging from 850 to 1600 cells/mm2 Two of the six animals receiving larger grafts developed fibrinous reactions in the immediate postoperative period, and the grafts never cleared. Three showed a satisfactory early course, but after 10-16 days, developed endothelial keratic precipitates, anterior chamber reaction, and progressive graft edema. The sixth graft remained technically satisfactory 1 year later. This study indicates that the application of small human donor grafts in monkey eyes can provide a useful, clinical model for the future exploration of the response of human corneal transplants to materials such as epidermal growth factor and for the study of surgical manipulation of postkeratoplasty astigmatism.
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PMID:A primate model of human corneal transplantation. 638 73

Terrien's marginal degeneration (TMD) is a bilateral and progressive corneal disorder that causes corneal thinning, furrowing, neovascularization and high degrees of corneal astigmatism. Possible sequellae include ectasia and perforation of the affected corneal region. An asymptomatic patient presented to our clinic manifesting all of the classical signs of TMD except the high degree of corneal astigmatism. Excellent visual acuity was attained with the latest spectacle prescription.
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PMID:Terrien's marginal degeneration. 660 24

Terrien's disease is an uncommon (Terrien himself saw only three cases in thirty years of practice) corneal condition characterized by vascularization, opacification, lipid deposition, and thinning. With progression, large degrees of astigmatism occur and perforation is a threat. One-third of cases exhibit an inflammatory component. While typically described as a disease of middle to late age, these four cases indicate the full spectrum of clinical disease may be seen by an ophthalmologist who cares for children.
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PMID:Terrien's marginal corneal degeneration. 698 Feb 70


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