A Clinical Case of Fitting Scleral Lens for Correction of Pellucid Marginal Degeneration

Abstract

Background. Pellucid Marginal Degeneration (PMD) is a rare bilateral degenerative corneal disease. It causes corneal ectasia with bilateral, clear, inferior (typically 4 o’clock to 8 o’clock), peripheral corneal thinning. It usually affects about 80% of corneal stroma, which leads to the corneal ectasia above the thinning area as well as provokes the irregular astigmatism and visual impairment that are difficult to correct. 
Purpose. To study the possibilities of correction and social rehabilitation in a patient with PMD wearing scleral lenses. 
Materials and methods. The study included a patient with PMD, signs of corneal dysfunction and narrow-angle subcompensated glaucoma in the right eye, and PMD of the cornea resulted in a corneal leukoma – terminal glaucoma in the left eye. In addition to standard ophthalmic methods, we performed corneal topography and optical coherence tomography (OCT). For intraocular pressure measurement, ICARE IOP tonometer was used in several areas of the intact peripheral cornea. 
Results. Prior to lens fitting, UCVA in the right eye amounted to 0.06. Scleral lens helped achieve a high visual acuity of 0.9–1.0. The lens was well-tolerated by the patient. 
Conclusion. Scleral lenses may be a good choice for patients with irregular cornea caused by corneal dystrophy. Not only they are easy to use and have a good visual effect, but they also help patients with social rehabilitation.