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[Keratectomy and cataract extraction in Terrien disease]
Klinische Monatsblatter Fur Augenheilkunde
|November 1, 1985
Summary
This study presents a surgical approach for advanced Terrien's disease, achieving significant visual improvement and reduced astigmatism through keratectomy and advanced wound closure techniques.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Tissue Engineering
Background:
- Terrien's marginal degeneration is a bilateral, progressive thinning of the peripheral cornea.
- Advanced stages (Stage V) may preclude conventional surgical interventions.
- Surgical management often involves addressing stromal thinning and associated visual impairment.
Observation:
- A 36-year-old patient with bilateral Terrien's disease presented with Stage V involvement in the right eye.
- Surgery was not feasible for the right eye; Stage III of the left eye underwent thoroughgoing keratectomy, cataract extraction, and coreplasty.
- Descemet's membrane was absent in the affected corneal region.
Findings:
- Optimal wound healing was achieved using a combination of biosutures, monofil sutures, and biological tissue cement (Tissucol).
- The keratectomy successfully reduced corneal astigmatism from 11 to 4 Diopters.
- Post-operative visual acuity of 0.4 was attained with corrective lenses in the treated eye.
Implications:
- This surgical technique offers a viable option for managing advanced Terrien's disease, even with Descemet's membrane absence.
- Combined keratectomy, cataract extraction, and coreplasty can significantly restore visual function.
- The use of biological tissue cement facilitates optimal wound healing in complex corneal procedures.