![]() The 3d video constructed using this data is particularly elucidative compared to 2d images. Using the gonioscopic three-dimensional optical coherence tomography imaging, we were able to easily visualize the massive intrastromal cavern, and appropriately planned the crescent-shaped anterior lamellar keratoplasty. This appears to be a very rare and interesting presentation of bilateral pellucid marginal degeneration, wherein not only acute hydrops formed bilaterally, but the cavity within the cornea stroma was exceptionally large with an unusual shape. Patient history revealed a previous acute hydrops in the right eye as well, which was ultimately treated with anterior lamellar keratoplasty, suggesting the pellucid marginal corneal degeneration had a classic bilateral involvement, which was also characterized with bilateral acute hydrops. We visualized it via a gonioscopic three-dimensional optical coherence tomography to build a three-dimensional video. The Descemet membrane rupture allowed acute hydrops to occur which was especially noteworthy given the scale of edema present within the stroma, rotating 180 degrees along the limbus, causing a smiley-face like lesion. Anterior segment optical coherence tomography-based corneal topography revealed a distorted crab claw sign indicating pellucid marginal corneal degeneration. Case presentationĪ 41-year-old Japanese woman presenting with severe visual loss in the left eye was examined and observed to have had full thickness corneal perforation as well as a Descemet membrane rupture with massive edema in the corneal stroma. Additionally, acute hydrops can occur in case of Descemet’s membrane rupture. ![]() The central portion of the cornea, consequently, appears to protrude outwards, decreasing vision by means of an irregular stigmatism. Pellucid marginal corneal degeneration is a non-inflammatory disorder complicated by severe inferior corneal thinning.
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