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

Pellucid marginal degeneration of the cornea is a bilateral, clear, inferior, peripheral corneal-thinning disorder. Protrusion of the cornea occurs above a band of thinning, which is located 1 to 2 mm from the limbus and measures 1 to 2 mm in width. American ophthalmologists are generally not familiar with the condition because most of the literature concerning pellucid degeneration is European. Four cases are described. This condition is differentiated from other noninflammatory cornel-thinning disorders such as keratoconus, keratoglobus, keratotorus, and posterior keratoconus. It is also differentiated from peripheral corneal disorders associated with inflammation such as Terrien's peripheral corneal degeneration, Mooren's ulcers, and ulcers from connective tissue disease.
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PMID:Pellucid marginal corneal degeneration. 35 10

A case of scleromalacia perforans in a 60-year-old white male without any associated systemic diseases is reported. The patient had central retinal artery occlusion and Mooren's type of peripheral corneal degeneration in this eye preceding the development of scleromalacia. Various modalities of treatment, both medical and surgical, have been described in the literature and among surgical procedures various tissues were used as graft material in the areas of scleral thinning. We chose periosteum as the graft material on the basis of our experience with it in cases of "through-and-through" keratoprosthesis and the result has been very encouraging. Though our experience is limited to only one case, we feel that periosteum as graft material has a place in cases of scleromalacia.
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PMID:Periosteal graft in scleromalacia. 60 Apr 83

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

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

The type of corneal ectasia, the presence of breaks in Descemet's membrane, and the success with contact lens wear or penetrating keratoplasty were studied in 61 patients with corneal ectasia and vernal keratoconjunctivitis. There were 53 patients with keratoconus, 5 with pellucid marginal corneal degeneration, 2 with keratoglobus, and 1 with superior corneal thinning. The high rate of hydrops and the corneal ectasia itself may be related to excessive eye rubbing. Success with contact lens wear or penetrating keratoplasty in vernal keratoconjunctivitis patients with keratoconus is less than in patients with keratoconus alone.
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PMID:Corneal ectasia in vernal keratoconjunctivitis. 261 47

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

Three patients had pellucid marginal corneal degeneration complicated by corneal edema. The corneal edema appeared to be a result of a break or detachment of Descemet's membrane as a result of increasing corneal ectasia. The disruption in Descemet's membrane began just above the inferior, crescent-shaped area of stromal thinning. Therapeutic modalities initially included hypertonic solution to determine whether corneal edema would resolve spontaneously, apparently by endothelial migration with healing over the break in Descemet's membrane. One patient required thermokeratoplasty and another penetrating keratoplasty for persistent stromal edema. Acute hydrops can occur with pellucid marginal corneal degeneration by a pathogenesis similar to other noninflammatory corneal thinning disorders such as keratoconus.
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PMID:Acute hydrops in pellucid marginal corneal degeneration. 264 81

Pellucid marginal corneal degeneration is a bilateral disease characterized by a narrow band of corneal thinning localized 1-2 mm from the inferior limbus. The disease is diagnosed usually between 20 and 50 years of life, and its etiology remains obscure. During the clinical course and evolution of pellucid marginal corneal degeneration, acute hydrops with corneal edema in the lower half may develop (acute pellucid marginal corneal degeneration). However, since cases of acute pellucid marginal corneal degeneration are not frequently encountered in clinical practice, each new patient is evaluated and managed with the utmost care to contribute to our better understanding of this disease. This is a report of two cases of acute pellucid marginal corneal degeneration that had a relatively favorable functional outcome when treated medically, so that corneal grafting was not necessary.
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PMID:Acute pellucid marginal corneal degeneration. 321 64

A 15-year-old female showed classical signs of Terrien's corneal degeneration including peripheral corneal thinning, vascularization, lipid deposition, and ectasia. She also showed episodes of conjunctival inflammation and perforation following minor trauma, all in the presence of an intact epithelium. She also showed progressive central corneal thinning and opacification, features not reported in the literature in the last 30 years.
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PMID:Central cornea involvement in Terrien's degeneration. 685 43

This paper presents a brief historical review and details of one case of this condition. Terrien's marginal corneal degeneration involves a relatively painless degeneration of the superior corneal stroma, with the most prominent clinical finding being the marked irregular astigmatism which accompanies the corneal thinning.
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PMID:Terrien's marginal corneal degeneration: a case report. 732 3


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