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Pathology: 

Pellucid marginal degeneration is a slowly progressive corneal ectatic condition often leading to severe visual impairment of working age people.
The peripheral corneal thinning location requires a large graft size, eventually a peripheral lamellar crescentic keratoplasty followed by a central penetrating keratoplasty.
Besides surgically more challenging, corneal transplantation is associated to increased risk of vascularization and rejection.

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