Endothelium sparing – Air-assisted wedge resection for the treatment of pellucid marginal degeneration

Abstract

To describe the surgical technique of performing a wedge resection of a 1 mm area of inferior corneal stroma using stromal air injection assisted separation sparring the endothelium in a patient with bilateral Pellucid Marginal Degeneration. 68-year-old male Caucasian advanced, non progressive. A 30G needle on a 1 ml air-filled syringe injects air into the stromal lamellae with the bevel up, leading to stromal emphysema. An MVR blade is used to incise the marked area until clear corneal tissue is seen. The incised areas are separated with a lamellar dissector, and the crescentic area is excised. The lips of the wound are approximated with 10-0 Prolene sutures. This surgical approach leads to adequate management of the Pellucid Marginal Degeneration without injury to the endothelium, ensuring reduced antigenic input and maintenance of the architectural integrity of the eye.