RECURRENT BILATERAL SALZMANN NODULAR DEGENERATION POST-MYOPIC LASIK IN A KELOID-PRONE PATIENT
Published 2025
- 29th ESCRS Winter Meeting
Reference: PO080
| Type: Presented Poster & Poster
| DOI:
10.82333/v4x4-6045
Authors:
Konstantinos Papadopoulos* 1
, Tariq Mohammad 1
, Nevien Lotfy 1
, Mohamed Elalfy 2
, Artemis Matsou 1
1Corneo-plastic Unit,Queen Victoria Hospital NHS Foundation Trust,East Grinstead,United Kingdom, 2Corneo-plastic Unit,Queen Victoria Hospital NHS Foundation Trust,East Grinstead,United Kingdom;The Research Institute of Ophthalmology,Cairo,Egypt
Purpose
To present a rare case of a patient with recurrent bilateral Salzmann nodular degeneration after Myopic laser in situ keratomileusis (LASIK) surgery.
Setting
Corneo-plastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, United Kingdom.
Methods
A 40-year-old Asian male referred to our clinic for management of aggressive recurrent bilateral Salzmann’s nodular degeneration (SND). The patient had undergone uneventful bilateral femtosecond LASIK for moderate myopic correction 12 years prior. Five years later, the patient experienced a notable visual decline in both eyes along with ocular surface disease symptoms. Examination revealed bilateral elevated, white corneal lesions consistent with SND. He subsequently underwent bilateral superficial keratectomies, at the same facility where the original LASIK surgery took place. Despite this, SND reoccurred in both eyes within 3 months from treatment. Upon presentation to our clinic, slit-lamp examination revealed extensive, bulky, dense scarred tissue along the LASIK flap margins in both eyes. Predisposition for keloid formation was noted. The patient underwent superficial left eye (LE) keratectomy with mitomycin C (0.02%), orbital floor triamcinolone, and amniotic membrane transplantation.
Results
There was a further recurrence at 8 weeks. The temporal margin interestingly however showed development of pseudo pterygium away from the LASIK flap. He was treated with topical cyclosporin and monitoring. He underwent similar procedure to right eye (RE). No recurrence has been noted in the RE whereas lesions in the LE had remained stable.
Conclusion
SND is a rare cause of decreased visual acuity and irregular astigmatism after LASIK surgery. Treatment with superficial keratectomy in symptomatic patients has variable results.