Chesnutt D A, Cohen K L
Department of Ophthalmology, University of North Carolina at Chapel Hill, 27599-7040, USA.
Cornea. 1998 Mar;17(2):236-8.
To report visually disabling postkeratoplasty astigmatism occurring 12 years after a corneal transplant for keratoconus apparently caused by pellucid marginal corneal degeneration (PMD).
A 33-year-old woman had had a corneal transplant for keratoconus in her left eye. Twelve years later, she was referred for evaluation and management of increasingly blurred vision due to marked postkeratoplasty astigmatism.
The donor cornea protruded over a region of thinning, anterior to and concentric with a thinned inferior wound. Videokeratoscopy showed +18.35 D of astigmatism in the 34 degree meridian and inferior corneal steepness surrounding the region of inferior flatness.
To our knowledge, this is the first case of apparent PMD occurring after corneal transplantation for keratoconus. The presence of subtle biomicroscopic and keratoscopic signs of PMD prior to corneal transplantation for keratoconus may affect the planned surgical approach.
报告圆锥角膜行角膜移植12年后出现的导致视力障碍的角膜移植术后散光，该散光显然由透明边缘角膜变性（PMD）引起。
一名33岁女性左眼曾因圆锥角膜接受角膜移植。12年后，她因角膜移植术后明显散光导致视力日益模糊而前来接受评估和治疗。
供体角膜在变薄区域上方突出，该区域位于下方变薄伤口的前方且与之同心。角膜地形图显示在34度子午线有+18.35 D的散光，且下方平坦区域周围角膜陡峭。
据我们所知，这是圆锥角膜角膜移植术后出现明显PMD的首例病例。圆锥角膜角膜移植术前存在PMD的细微生物显微镜和角膜镜体征可能会影响手术方案的制定。
