![]() ![]() Ziel der Studie: Evaluation der Effektivität und Sicherheit des Kollagen-Crosslinkings der Hornhaut mit Riboflavin und UV-A (CXL) bei progressivem Keratokonus über einen Nachbeobachtungszeitraum von bis zu 10 Jahren. In both eyes the topographic maps failed to identify any areas of increased corneal power inferiorly. The area of greater power is presented in a 'bow-Tie' configuration of two semimeridians inferior and oblique to the horizontal axis. In early PMCD the power of the cornea is lowest at a vertical axis very close to 90 degrees. The left eye shows enantiomorphic symmetry (mirror image) to the right eye, with 11.9 DC of against-the-rule astigmatism. The right eye shows against-the-rule astigmatism of 10.6 DC. (c) The corneal topographic maps (absolute scale). It can also be seen that the keratoscopic mires are hardly covering the area where the peripheral corneal thinning occurs. The left eye of the same patient had an identical mirror videokeratoscopic image. (b) Videokeratoscopic image of the right eye shows a typical pear-shaped image with compression of the inferior rings. Inferior corneal thinning was observed (arrow) 1-2 mm from the limbus, extending from the 5 to 8 o'clock positions in both eyes of case 1. (a) Slit photography of the right eye (pellucid marginal corneal degeneration). However, although the finding of PMCD and keratoconus in fellow eyes has been reported, to the best of our knowledge progression from PMCD to keratoglobus has not previously been shown.Ĭase 1. Keratoconus, PMCD and keratoglobus are considered to be associated as part of the spectrum of non-inflammatory corneal thinning disorders. Corneal topography suggested that in the second patient, PMCD may have preceded the development of keratoglobus. The other eye showed both clinically and topographically the features of PMCD. The second case had an uncommon presentation of hydrops in a clinically keratoglobic eye which showed a marked steepening of the inferior corneal periphery on corneal topography. The first case is a clinically typical bilateral PMCD with a characteristic pattern of irregular against-the-rule astigmatism on corneal topography. Although histopathologically it is considered a variant of keratoconus, it differs in that the marked corneal steepening occurs more inferiorly, above a narrow band of corneal stromal thinning concentric to the inferior limbus. Pellucid marginal corneal degeneration (PMCD) is an uncommon cause of inferior peripheral corneal ectasia, affecting patients between the ages of 20 and 40 years. ![]()
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