Bilateral Salzmann-like nodular corneal degeneration after laser in situ keratomileusis imaged with anterior segment optical coherence tomography and high-frequency ultrasound biomicroscopy

VanderBeek, Brian L.; Silverman, Ronald H.; Starr, Chauncey

doi:10.1016/j.jcrs.2008.09.033

Cited by 24 publications

(23 citation statements)

References 8 publications

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“…High-resolution anterior segment OCT confirmed that the nodules were subepithelial and not within the LASIK flap interface, as has been suggested by other authors 2. Histological analysis of the nodule was consistent with that previously described for Salzmann nodules4 5 and confirmed the findings from OCT 6.…”

Section: Discussionsupporting

confidence: 89%

“…Some authors have speculated that exacerbation of dry eye syndrome contributes to the formation of Salzmann nodules after LASIK 1 2. Although dry eyes cannot be ruled out as a solitary cause in our patient, the lack of significant clinical findings of dry eye syndrome (including punctate epithelial erosions), the unilaterality of the nodules and the distribution of the nodules overlying the epithelial ingrowth lead us to hypothesise that the presence of epithelial ingrowth itself was a contributing factor.…”

Section: Discussionmentioning

confidence: 59%

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Salzmann nodular degeneration associated with epithelial ingrowth after LASIK treated with superficial keratectomy

Stem

Hood

2015

BMJ Case Reports

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SUMMARYA 41-year-old woman who underwent uncomplicated LASIK and two subsequent flap lifts for epithelial ingrowth of the right eye became progressively symptomatic with blurred vision, photophobia and foreign body sensation over the ensuing 5 years. Clinical examination of the right eye demonstrated extensive epithelial ingrowth around the flap periphery with overlying Salzmann nodules in the same distribution. Similar findings were not present in the left eye. Anterior segment optical coherence tomography demonstrated subclinical flap elevation in the areas of epithelial ingrowth, which may have predisposed to nodule development due to a dellen effect. The patient underwent superficial keratectomy with significant improvement of her symptoms. BACKGROUND

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 59%

Salzmann nodular degeneration associated with epithelial ingrowth after LASIK treated with superficial keratectomy

Stem

Hood

2015

BMJ Case Reports

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“…In most cases tissue samples are not available for histological examination and previous histological studies have been performed in advanced cases requiring penetrating or lamellar keratoplasty. The only study about the use of OCT imaging in Salzmann nodular degeneration has reported the morphology of a bilateral case, which developed after LASIK (13). However the low resolution of time domain anterior segment OCT prevented the authors from documenting the detailed morphology of Bowman’s layer underneath and epithelium overlying the Salzmann nodular degeneration lesions.…”

Section: Discussionmentioning

confidence: 99%

In Vivo Morphologic Characteristics of Salzmann Nodular Degeneration With Ultra-High-Resolution Optical Coherence Tomography

Hürmeriç

Yoo

Karp

et al. 2011

American Journal of Ophthalmology

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Purpose To examine the in-vivo morphological properties of Salzmann nodular degeneration with ultra-high-resolution optical coherence tomography (OCT). Design Interventional case series. Methods Setting Single-center, academic practice. Study Population 19 eyes of 12 patients with Salzmann nodular degeneration were recruited to participate in the study. Observational Procedure Subjects were imaged using novel, custom-built ultra-high-resolution OCT. Images were used to describe in-vivo characteristics of subepithelial nodules. Morphometric measurements were made with custom-built software. Ultra-high-resolution OCT findings were compared with histopathological findings in three patients. Main outcome measures To demonstrate in-vivo morphological characteristics of Salzmann nodular degeneration with ultra-high-resolution OCT. Results Ultra-high-resolution OCT images demonstrate intraepithelial fibrous nodules with epithelial thinning and corneal surface elevation. Bowman’s layer could be differentiated in 9 of 12 patients. The difference between the mean thickness of epithelium above the nodule and the thickness of normal epithelium was statistically significant (p < 0.0001). The correlation between thickness of the epithelium and thickness of the nodule was statistically significant (r = -0.48; p < 0.0001). The correlation between thickness of the nodule and total surface thickness (thickness of the epithelium + thickness of the nodule) was statistically significant (r = 0.98; p < 0.0001). Ultra-high-resolution OCT findings were consistent with histopathological results. Conclusions Ultra-high-resolution OCT can be used to non-invasively image the cornea in Salzmann nodular degeneration. This new imaging technique helps us to demonstrate different in-vivo morphological characteristics of Salzmann nodular degeneration.

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“…OCT can be used to assess the morphology of these nodules [40, 41]. Many of the established histopathologic findings can be seen using the Visante OCT in vivo [41].…”

Section: Role Of Oct In Excimer Laser Phototherapeutic Keratectomymentioning

confidence: 99%

Role of Optical Coherence Tomography on Corneal Surface Laser Ablation

Ventura

Moraes

Kara-Júnior

et al. 2012

Journal of Ophthalmology

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This paper focuses on reviewing the roles of optical coherence tomography (OCT) on corneal surface laser ablation procedures. OCT is an optical imaging modality that uses low-coherence interferometry to provide noninvasive cross-sectional imaging of tissue microstructure in vivo. There are two types of OCTs, each with transverse and axial spatial resolutions of a few micrometers: the time-domain and the fourier-domain OCTs. Both have been increasingly used by refractive surgeons and have specific advantages. Which of the current imaging instruments is a better choice depends on the specific application. In laser in situ keratomileusis (LASIK) and in excimer laser phototherapeutic keratectomy (PTK), OCT can be used to assess corneal characteristics and guide treatment decisions. OCT accurately measures central corneal thickness, evaluates the regularity of LASIK flaps, and quantifies flap and residual stromal bed thickness. When evaluating the ablation depth accuracy by subtracting preoperative from postoperative measurements, OCT pachymetry correlates well with laser ablation settings. In addition, OCT can be used to provide precise information on the morphology and depth of corneal pathologic abnormalities, such as corneal degenerations, dystrophies, and opacities, correlating with histopathologic findings.

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Bilateral Salzmann-like nodular corneal degeneration after laser in situ keratomileusis imaged with anterior segment optical coherence tomography and high-frequency ultrasound biomicroscopy

Cited by 24 publications

References 8 publications

Salzmann nodular degeneration associated with epithelial ingrowth after LASIK treated with superficial keratectomy

Salzmann nodular degeneration associated with epithelial ingrowth after LASIK treated with superficial keratectomy

In Vivo Morphologic Characteristics of Salzmann Nodular Degeneration With Ultra-High-Resolution Optical Coherence Tomography

Role of Optical Coherence Tomography on Corneal Surface Laser Ablation

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