Our patient presented with progressive decreased vision in the left eye and was found to have significant thinning of the inferior cornea associated with corneal neovascularization and lipid deposition, which was worse in the left than the right eye. Inflammatory lab workup was negative. Serial examinations demonstrated increased thinning especially in the left eye, increasing the risk of corneal perforation. The clinical presentation resembled Terrien Marginal Degeneration. A tectonic lamellar keratoplasty in the left eye was performed to enhance integrity of the thin cornea followed by an optical penetrating keratoplasty. The surgery was tolerated well with a final visual acuity of 20/30 in the operated eye. Serial examinations are scheduled to ensure no graft failure in the surgical eye and to monitor progression of thinning in the nonsurgical eye.
Presentation Date: 10/20/2022
Issue Date: 12/09/2022