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CASE REPORT
Year : 1984  |  Volume : 32  |  Issue : 2  |  Page : 113-114

Keratectomy in terriens marginal degeneration


Department of Ophthalmology, Little Flower Hospital, Angamaly, India

Correspondence Address:
Alex Joseph
Ophthalmic Surgeon, St. John's Hospital, Kattappana (Kerala)
India
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Source of Support: None, Conflict of Interest: None


PMID: 6526462

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How to cite this article:
Joseph A, Fernandez S T, Ittyarath T P, Williams J. Keratectomy in terriens marginal degeneration. Indian J Ophthalmol 1984;32:113-4

How to cite this URL:
Joseph A, Fernandez S T, Ittyarath T P, Williams J. Keratectomy in terriens marginal degeneration. Indian J Ophthalmol [serial online] 1984 [cited 2021 Jan 21];32:113-4. Available from: https://www.ijo.in/text.asp?1984/32/2/113/27385

Terriens marginal degeneration of the cor­nea is a rare bilateral condition starting with opacifications and vascularistion of the pe­riphery of the cornea, progressing by dege­neration of the stroma to the formation of a gutter and finally resulting in ectasia and rup­ture.[1] This is an uncommon condition. The condition exist more frequently in males than in females (3:1)[3] and one third of the total cases are seen below the age of 40 years[1].

The treatment of the condition is disap­pointing. Procedures like repeated cauterisa­tion, conjunctival flapping, cyclodiathermy, keratectomy, keratoplasty etc. were tried in an attempt to prevent the progress of the condi­tion. The purpose of this present com­munication is to report a case of unilateral Terriens marginal degeneration treated suc­cessfully by keratectomy and conjunctival flapping.


  Case report Top


A 37 year old male was first seen with defec­tive vision in his left eye of 8 years duration. He was changing his glass very frequently without much improvement. Ophthalmic examination results were as follows:- Right eye was within normal limits with a vision of 6/6. Left Eye vision was 3/60 and the refrac­tion value was+8.00 Sph with -16.00 cyl at 100". Inspection of the comes as showed an arcuate opacity along the margin of the lower half of the cornea. The lower part of the cor­nea was bulging and irregular. Bio-microscopic examination revealed a shallow gutter in the lower periphery of the cornea with some vas­cularisation of the floor. Epithelium was intact. Anterior Chamber, Iris, Pupil and lens were normal. Corneal sensation was reduced on the floor of the gutter. Fundus was normal. General physical examination and routine laboratory blood, urine and motion inves­tigations were non-contributory.

The patient was admitted and a full thick­ness Keratectomy excision of diseased tissue was done under local anaesthesia. The dis­eased part of the cornea was marked out with a special trephine designed by us (used for corneal section in cataract extraction). The marked out part of the cornea was excised. Two peripheral button hole iridectomies were done. The cornea was sutured with 8'O virgin silk.

The wound was reinforced with a con­junctival flap. Daily dressing was done and the patient was discharged on tenth post operative day. Release of the conjunctival flap and suture removal were done after three weeks. The vision improved to 6/9 with a cor­rection of +2.50 cyl at 90°. Now it is 21/2 years and condition remains stationery with the same refraction value and vision.


  Summary Top


A case of unilateral Terrien's Marginal degeneration in a 37 year old male treated with Keratectomy and conjunctival flapping is being reported.

 
  References Top

1.
Duke Elder S., 1965, System of Ophthalmology, London Kimption Vol. VIII Part 11 909-913.  Back to cited text no. 1
    
2.
Etzine S. Friedman, 1963, Amer. J. Ophthalmol.55:105.  Back to cited text no. 2
    
3.
Gurbex Singh and Malik SRK,1978, Ind. J. Ophthal­ mol. 26, 11, 30.  Back to cited text no. 3
    


    Figures

  [Figure - 1], [Figure - 2]



 

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