Traditionally, pellucid marginal degeneration was treated with a large-diameter penetrating keratoplasty that extended to the limbus once scleral contact lenses could not be used or tolerated. The presenters demonstrate a wedge resection of a 1-mm area of inferior corneal stroma using pneumatic separation of the posterior stroma/Descemet membrane. The 2 edges are approximated using 10-0 Prolene sutures that remain in place. A 12 D and 10 D corneal flattening was achieved in the 2 operated eyes, respectively, and the patient was able to tolerate a glasses prescription that led to a 0.7 best-corrected visual acuity (BCVA) and 0.8 Early Treatment Diabetic Retinopathy Study (ETDRS) score in the 2 respective eyes. This novel technique is an improvement of the already established wedge resection. The technique described enables preservation of an intact endothelial layer using minimal surgical maneuvers, leading to a functional visual outcome with fast rehabilitation.

Financial Disclosures: Drs. Ioannis Athanasiadis and Michael Tsatsos disclose no financial relationships.