Pellucid Marginal Degeneration

[chutley]

45 years old. Astigmatism and myopia in my teens. Laser surgery on left eye in 1990, which regressed. Subsequently diagnosed with KC in 1991. Managed with GP lenses. Fast forward 20 years and GP lenses warping cornea so not keeping a regular prescription - after taking them out prescription changes over hours and days. The RGP lenses were acting as a bandage andkept cone in shape.

New Opthalmic surgeon and Optician who specialises in KC have not made me keep, lenses out for a month. Prescription has stabilised:
R -2.5 sph -7.0 Cyl 85 axis
L -2.00 sph -0.75 cyl 110 Axis

Now they think that I have Pellucid Marginal Degeneration - more evident in my right eye. In fact, the laser treatment actually helped flatten the left cornea and I can get excellent 6/6/ vision with glasses or soft lenses. My right eye is less good and I am struggling to get as good vision with a soft lens or indeed glasses. Now to my point. Is there any way I can get laser treatment to fletten the cornea a little and reduce some of the astigmatism in the lower quadrant of the cornea. Not removing corneal cells to try and get good vision unaided, just to help fit lenses??

Alternatively, can I get a toric Intraoccular lens fitted?

Anybody else out ther with PMD??

[Andrew MacLean]

chutley

Welcome to the forum. I don't have PMD, but I know that there are others on the forum who do.

Every good wish.

Andrew

[metallic201001]

Check out in the web about Dr. Kanellopolous or Dr. Cummings in the web.
The are experts about flattening Keratoconus eyes with laser and CXL.

google for " Athens protocol" or "SimLC"
Regards

Andi

[caroline6505]

Hi

Yup, I've got PMD. My understanding is that PMD is a rare type of KC and that characteristically it can affect up to 50% of the cornea, generally the bottom areas. In something around 15-18% of PMD sufferers end up having grafts. However, I've been advised that there are options (different in each case).

I was told about 10 years ago that it was KC I had, however, over the past year I became more and more aware that my eyesight had deterioriated (prior to that, I was given the impression by my opticians that it had stopped). I went for a checkup to the opticians and was dissatisfied in their level of service i.e. being charged £325 for glasses that made no difference whatsoever and being told that the KC hadn't progressed much and was still mild. Cut a long story short, I demanded a refund on the glasses and spent that money on a consultation at the Centre for Sight. I was shocked to be told that I actually had a type of KC/PMD and that my left eye was mild, but right eye was quite advanced. Anyhow, I had my right eye crosslinked last Tuesday and will go back next month and have a checkup and have the left eye done at the same time. Once my right eye is stable enough, the plan is to have a wedge resection in order to regain shape and hopefully some vision too! (at the moment, I struggle to read the top line on an eye chart - left eye is 6/12 and right is 6/24).

Best wishes.

Caroline.

[Accuvision Optom]

Hi Chutley,

There could well be surgical options for you. The only way to find out is to have an appropriate consultation.
At Accuvision we have safely treated patients like yourself.

We would be happy to assess the pros and cons of laser treatment versus intraocular implants,
as we have lots of experience with both.

Anthony

[Lynn White]

Hi Chutley,

First of all, it can be difficult to distinguish between a cone that is very low and true PMD. Your prescription could indicate either of these conditions and certainly, Low cone is easier to treat surgically/fit with lenses than PMD. Ironically, it is actually easier to fit this type of cornea with soft lenses than rigid types because they can drape over the rather complicated corneal shape. Therefore, you need to clarify this with your professionals first and ask their opinion as to the types of surgery that are most suitable for you.

Whether you look at Intra Ocular implants or laser surgery, it is advisable to have cross linking with either option, to stabilise the condition and prevent further progression.

One of the issues always to consider is that any laser treatment, even on the thicker part of the cornea (which is where it is done in order to do reshaping) is essentially thinning a compromised cornea. It is just something you need to think through and understand before you have this done.

Lynn