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Coincident Pellucid Marginal Degeneration and Fuchsiridocyclitis: a case report
1Unit of Ophthalmology, Department of Surgery, Faculty of Medicine, Al-Baha University, Al-Baha, 65431, Saudi Arabia.
Introduction & Importance:
We report a rare coexistence of Pellucid Marginal Degeneration (PMD) and Fuchs' heterochromic iridocyclitis (FHI) in a 40-year-old female. The overlap of corneal ectasia and chronic uveitis created significant diagnostic and surgical challenges, highlighting the importance of individualized planning in complex anterior segment diseases.
Case Presentation:
The patient presented with painless, progressive visual decline in the right eye. Clinical examination revealed inferior corneal thinning, mature cataract, pigmented keratic precipitates, and peripheral anterior synechiae (PAS). Corneal tomography confirmed PMD with a characteristic "crab-claw" pattern. The patient underwent phacoemulsification with posterior chamber intraocular lens implantation. Postoperatively, visual acuity improved, although optic disc cupping and persistent PAS underscored the need for long-term glaucoma surveillance.
Clinical Discussion:
The coexistence of PMD and FHI is exceptionally rare. PMD complicates surgical planning by affecting keratometric reliability and corneal biomechanics, while FHI contributes to cataract formation, intraocular inflammation, and risk of secondary glaucoma. Multimodal imaging, tailored surgical strategy, and vigilant postoperative follow-up are key to optimizing outcomes.
Conclusion:
Simultaneous PMD and FHI represent a unique clinical entity requiring comprehensive assessment and individualized management. Tailored surgical planning and vigilant surveillance are essential to preserve vision and mitigate long-term risks.
