UK Keratoconus Self-Help and Support Association

I visited the LCRS (London Centre for Refractive surgery) yesterday for my consultation. Mr Jory described my eye condition as pellucid marginal degeneration and has advised me to consider intacs and collagen cross linking. Has anyone else got PMD and if so what treatments have you had for it?

BTW I was very impressed with the in-depth investigations and tests carried out by the LCRS in their FREE consultation.

You can find an article on PMD at

http://www.lensdesign.ca/pmd.htm

I am not sure whether PMD and KC are the same thing? Did the consultant mention a connection?

Anyhow, the standard method of managing PMD seems to have been, like KC, contact lens wear, but I am afraid I know nothing about the use of Intacs or CXL in the treatment and management of PMD.

ps I found another article that traces similarities between PMD and KC

http://www.revoptom.com/index.asp?page=2_1595.htm

I have a wicked case of PMD. From what I understand, the difference is the cone is usually offset and not centered on the eye, and there is an extremely flat band. I notice that some objects at a certain angle have a very sharp, defined edge.

My PMD responded very well to Intacs and C3R, but the recovery time was longer than for KC. Personally, I would not wait to get treatment. Depending on the location of the cone and the portion of the cornea which is thinning (in PMD this is often very near the blood supply), you may not be a good candidate for a graft or transplant later on, so you'll want to stop the progression now.

As I understand it (not guaranteed!)
KC, PMD and something called Keratoglobus are all basically of the same root cause.
If the thinning is fairly central and the cone looks like Mount Fuji, it's called KC
If the thinning is further out and the "cone" look more like Table Mountain, it's called PMD.
If the thinning is all over and the "cone" is a huge big ball a bit like that big golf ball thing in the old pictures of Windscale (before it was Sellafield), it's Keratoglobus.
I've been at at least one talk on this where the speaker has put up slides and asked the audience which they would call this, and no-one's quite sure!
Rosemary

Hi

I have KC not PMD, but it seems as though they are offering the same treatment. I have had Collegen cross linking and intacs by that surgeon, (I am not sure if I am aloud to mention names). He is really good and thoroughly recommend you go there if you are going to have it done. I would get it done as the longer you leave it the more it will progress.

Hope this helps

Helen

Hi Helen!
Yes, it's fine to mention names - just so long as you are not going to say anything rude about the name you're mentioning.
I'm sure reports of good personal experiences wouldn't be a problem at all!
Rosemary

Hi Nelli...

Keratoconus is where the centre of the cornea thins and PMD thins towards the edge of the cornea. If you are familiar with topography, then examples of both can be seen on these links I found.

PMD - http://www.la-sight.com/media/images/ca ... Atlas3.jpg

KC - http://www.google.co.uk/imgres?imgurl=h ... 6%26sa%3DN

These are contour maps of the eye which have been colour coded - blue for flatter curves and red for steeper. You will see the patterns are very different, the PMD being flatter down the centre. The red areas form the classic "crabs claw" or "birds kissing" pattern while the KC picture shows a central cone. PMD is related to KC in that it is caused by thinning of the cornea by weakening of the collagen fibres but is not "keratoconus" as the term "conus" refers to the shape of the central cornea as it bulges forward.

Apart from CXL/intacs, there are no other treatments as such for PMD - nor indeed for KC itself. Contact lenses allow you to see better but do not halt the progression. The intacs reshape your cornea into a better form and the CXL "stiffens it" so it stays that way. CXL has been around 8 - 10 years and the results have been very good so far.

Hope this helps and please ask away if you want more info!