Corneal Thinning and Opacity following Selective Laser Trabeculoplasty: A Case Report.

Aims: Selective laser trabeculoplasty (SLT) (Lumenis, Santa Clara, CA) was developed in 1999 as a means to lower IOP in patients with glaucoma. It is a relatively safe procedure. We report a rare side effect of corneal opacity and stromal haze with corneal thinning and hyperopic shift following SLT. Presentation of Case: Case report. Results: A 50 year-old Asian male who underwent SLT OD developed mild corneal edema and slightly elevated intraocular pressure (IOP) one day after procedure. He was prescribed anti-inflammatory drops. One week afterwards, he developed a small corneal abrasion centrally. He was given topical antibiotics and asked to continue antiinflammatory drops. On postoperative day 8, his corneal abrasion healed, but he developed stromal corneal haze. Topical steroids were begun. By postoperative week #2, his visual acuity and stromal haze had improved. His corneal thickness decreased from 600 μms to 468 μms. After one year, he had almost complete resolution of his corneal pathology but had residual corneal thinning and flattening. Discussion: Corneal stromal haze following SLT is a rare side effect. This can result in corneal scarring with corneal thinning and a hyperopic shift due to corneal flattening. Physicians and patients should be aware of this potentially vision threatening side effect. Conclusion: More studies are needed to identify risk factors for the development of corneal pathology following selective laser trabeculoplasty.

Long-term Follow-up of Terrien's Marginal Degeneration

PURPOSE: The purpose of this study is to investigate the long-term follow up of the patients with Terrien's marginal degeneration and to help the treatment of disease. METHODS: Eighteen (22 eyes) patients were selected who visited the Department of Opthalmology at Kangnam St. Mary's Hospital from 1994 to 2001 and were diagnosed with Terrien's marginal degeneration. The mean follow-up periods was 4.1 years. The distribution of lesion location and depth by slit lamp biomicroscopy, refraction by autorefractor and keratometry, and corneal topography were done. And we retrospectively analyzed age, sex, change of astigmatism, erythrocyte sedimentation rate by blood sampling, and serum level of C-reactive protein and rheumatoid factor. RESULTS: The range of age is from 11 to 74 years and the mean age of Terrien's marginal degeneration is 46 years. The superior nasal portion of cornea is most common site of Terrien's marginal degeneration. In 8 cases, axis of astigmatism is concordant with lesion site. And there were no statistically significant progression of cylindrical diopter changes except those undergoing intraocular surgery. Serum indicators of immunologic and inflammatory disease had no difference from normal value. CONCLUSIONS: Terrien's marginal degeneration occurs at any age without specific underlying causes such as immunologic or inflammatory disease. It is relatively safe and not vision threatening except severe forms of corneal thinning which affect astigmatism. Cases with corneal perforation require partial or full thickness corneal graft and have good prognosis

A Case of Unilateral Pellucid Marginal Corneal Degeneration Diagnosed by Computerized Topography

Pellucid marginal degeneration is a noninflammatory peripheral corneal thining disorder, which progresses slowly, affects inferior cornea bilaterally, occurs usually between twenties and fifties. Protrusion of the cornea with normal corneral thickness occurs above a band of thinning which is located 1 to 2mm from the limbus and measures 1 to 2mm in width and the patient complaints of progressive visual disturbance due to high irregular astigmatism. Topographically, the lowest corneal power is located along a narrow corridor of the central and peracental cornea and corneal power is highest along the inferior peripheral cornea and in the mid-peripheral cornea along the inferior oblique corneal meridian in a band-like fashion and is decreased slowly superior to that meridian. We experienced a case of pellucid marginal degeneration who had a history of progressive visual loss due to high irregular astigmatism. A 67 year-old woman had the characteristic topographic pattern and clinical feature of pellucid marginal degeneration only in her righ eye and we report it as the first case of unilateral pellucid marginal degeneration in Korea.

A Case of Unilateral Pellucid Marginal Corneal Degeneration Diagnosed by Computerized Topography

Pellucid marginal degeneration is a noninflammatory peripheral corneal thining disorder, which progresses slowly, affects inferior cornea bilaterally, occurs usually between twenties and fifties. Protrusion of the cornea with normal corneral thickness occurs above a band of thinning which is located 1 to 2mm from the limbus and measures 1 to 2mm in width and the patient complaints of progressive visual disturbance due to high irregular astigmatism. Topographically, the lowest corneal power is located along a narrow corridor of the central and peracental cornea and corneal power is highest along the inferior peripheral cornea and in the mid-peripheral cornea along the inferior oblique corneal meridian in a band-like fashion and is decreased slowly superior to that meridian. We experienced a case of pellucid marginal degeneration who had a history of progressive visual loss due to high irregular astigmatism. A 67 year-old woman had the characteristic topographic pattern and clinical feature of pellucid marginal degeneration only in her righ eye and we report it as the first case of unilateral pellucid marginal degeneration in Korea.

Two Cases of Pellucid Marginal Corneal Degeneration

Pellucid marginal degeneration is an uncommon, idiopathic, non-inflammatory, peripheral thinning disorder affecting the inferior cornea bilaterally. Protrusion of the cornea occurs above a band of thinning which is located 1 to 2mm from the limbus and measures 1 to 2mm in width. The disease is diagnosed usually between 20 and 50 years of age and its etiology remains obscure. We experienced two cases of pellucid marginal degeneration who had a histories of progressIve visual disturbance due to high irregular astigmatism. A 32 year old female(case.1) had the characteristic feature of pellucid marginal corneal degeneration with marked endothelial cell loss(OD. 624 +/- 32 cells/mm2, OS. 596 +/- 52 cells/mm2) in polymorphism. A 30 year old male(Case. 2) showed pellucid marginal corneal degeneration associated with rheumatoid athritis, but corneal endothelial cells appeared within normal ranges(OD. 2764 +/- 26, OS. 2812 +/- 34) with slight polymorphism. The Vision in these two cases improved to 20/20 with hard contact lens(Case. 1) and glasses(Case.2)