ESCRS - PO452 - Flap Amputation As A Last Option In A Case Of Salzmann's Nodular Pseudo-Degeneration After Femto-Lasik

Flap Amputation As A Last Option In A Case Of Salzmann's Nodular Pseudo-Degeneration After Femto-Lasik

Published 2022 - 40th Congress of the ESCRS

Reference: PO452 | Type: ESCRS 2022 - Posters | DOI: 10.82333/bmkm-1j59

Authors: Santiago Tañá-Sanz* 1 , Paz Paz Orts-Vila 1 , Robert Montés-Micó 2 , Pedro Tañá-Rivero 1 , Salvador Aguilar-Córcoles 1

1Oftalvist,Alicante,Spain, 2University of Valencia,Valencia,Spain

Purpose

We present a case of Salzmann's nodular pseudo-degeneration treated with multiple procedures in a patient who underwent Femto-Lasik 8 years after a pterygium exeresis.

 

Setting

Oftalvist Alicante (Spain)

Methods

A 50-year-old male patient with a history of uncomplicated Femto-Lasik for astigmatism correction after pterygium exeresis in the right eye presented a Salzmann's Nodular Pseudo-Degeneration causing corneal opacity accompanied by refractive change, decreased visual acuity and irregular astigmatism. He undergone Keratectomy, Cryotherapy, Nodular Resection, Corneal Scraping and 3 PTK , with no improvement since new nodules appeared after all the procedures, increasing its size and central epithelial growth moving towards the visual axis. Finally, amputation of the corneal flap had to be done.

Results

Keratometric improvement and increased corneal transparency were observed on OCT slices after flap amputation, with no hyperreflective areas of opaque tissue. The patient improved significantly, achieving visual acuity 20/20 and with no hyperopic shift.

 

Conclusions

Flap amputation may be the only effective treatment for Salzmann's nodular pseudo-degeneration in cases where no other treatments have been effective. It does not cause significant refractive changes and improves corneal transparency, which would be compromised in flaps performed with mechanical microkeratome.