Purpose:
To describe the surgical outcome of excimer laser phototherapeutic keratectomy (PTK) for Salzmann nodular degeneration.
Methods:
Retrospective review of cases. All patients treated with PTK for Salzmann nodular degeneration between January 2006 and August 2010 at the Cornea Service at Wills Eye Institute were included in this study. Demographic features, characteristics of corneal involvement, best corrected visual acuity and refraction prior and after PTK, surgical parameters, recurrence rate and need for further treatments were recorded.
Results:
64 eyes of 51 patients were identified .41 patients (80%) were female and 10 (20%) were male. The mean age of patients was 60.6 years (range 16 to 87). The mean follow-up time was 13.2 months (range 1 to 51). Main indications for treatment were decreased vision, glare, photosensitivity, foreign body sensation and contact lens intolerance. Preoperative mean logMAR best-corrected visual acuity (BCVA) was 0.31 (Snellen equivalent 20/40, range 0 to 1.3, SD 0.32). Postoperative mean logMAR BCVA was 0.21 (Snellen equivalent 20/32, range 0 to 1.3, SD 0.27). On average logMAR BCVA improved by 0.11 after surgery. The mean preoperative spherical equivalent and astigmatism were -0.56 D (range +5.25 to -8.50, SD 3.3) and 2.2 D (range 0 to 5.75, SD 1.4) respectively. The mean postoperative spherical equivalent and astigmatism were -1.68 D (range +4.50 to -10.25, SD 2.83) and 1.6 D (range 0 to 5.75, SD 1.43) correspondingly. On average there was 1.17D myopic shift in spherical equivalent and 0.6 D improvement in the amount of astigmatism after PTK. 8 eyes (15% of eyes with at least 3 month follow up) had some degree of recurrence after PTK. Only 2 eyes (3.1%) had to be retreated following recurrence.
Conclusions:
PTK is an effective method of treatment for Salzmann nodular degeneration with a low recurrence rate. Best corrected vision and the degree of astigmatism improved after PTK. In contrast to a hyperopic shift after PTK for stromal dystrophies, on average patients developed a 1.2 D myopic shift.
Keywords: cornea: epithelium • degenerations/dystrophies • laser