Surgical Treatment of Terrien Marginal Corneal Degeneration: A Case Report

Terrien's marginal degeneration is an infrequent, idiopathic degenerative disease that causes thinning, neovascularization, and lipid infiltration at the corneal periphery. It is usually bilateral but asymmetric. The classic form occurs predominantly in male patients over the age of 40 years and demonstrates extremely slow asymptomatic progression associated with minimal clinical and histological inflammation. However, an inflammatory type of the disease has been described, associated with sings of ocular inflammation (episcleritis, marginal keratitis). We present a clinical case of successful surgical treatment of a rare complication of Terrien's marginal degeneration with the formation of intracorneal cavities with spontaneous formation of a filtering bleb. Lamellar keratoplasty was performed in this case considering progressive cornea thinning and imminent corneal perforation. Surgical intervention allowed to restore the cornea integrity and preserve high visual acuity. The use of systemic and local immunosuppressive therapy was required to suppress inflammation and prevent recurrences.