We demonstrate adaption of anterior lamellar wedge resection to achieve satisfactory visual rehabilitation in pellucid marginal degeneration. Pre-operative visual acuity was 6/120 due to central scarring due to hydrops.
The surgical technique included the accurate measurement of a corneal arc utilising a range of corneal trephines, partial lamellar dissection of extremely thin peripheral corneal wedge with Melles dissectors, paracentesis to enable manipulation of cornea, and peripheral compression sutures.
Our video demonstrates successful restoration of physiological anterior segment relationships in a patient with extreme pellucid marginal degeneration. This wedge resection also created a new visual axis above the pre-existing scar, resulting an UAVA of 6/9 at 1 month.