Superficial keratectomy for Salzmann nodular degeneration following laser in situ keratomileusis

Xu, He; Donaldson, Kendall E.

doi:10.1016/j.jcjo.2018.07.002

Cited by 7 publications

(4 citation statements)

References 6 publications

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“…Studies showed that this method is effective in the treatment of RCES, with a success rate of 76% to 100% for simple SK ( 4 , 5 , 12 , 42 ) and 85.2% to 100 % for DBSK ( 13 – 17 , 19 – 21 , 43 , 82 ). In addition, SK improved BCVA and reduced the corneal astigmatism of patients with SND with a success rate of 78% to 100% ( 12 , 22 – 25 , 44 , 80 ). The success rate in patients with band keratopathy who managed with SK ranged from 72 to 100% ( 12 , 27 – 29 ).…”

Section: Discussionmentioning

confidence: 96%

“…Surgical methods that can be undertaken are SK, PTK and SK plus PTK ( 26 ). There are reports of managing SND of various etiologies with SK: thyroid eye disease ( 49 ), meibomian gland dysfunction ( 50 ), and post LASIK ( 22 , 51 ). Many modifications of SK have been proposed to reduce undesirable outcomes such as corneal haziness or reoccurrence of the symptoms.…”

Section: Indications For Superficial Keratectomymentioning

confidence: 99%

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Superficial Keratectomy: A Review of Literature

et al. 2022

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Superficial keratectomy (SK) is the manual dissection of the superficial corneal layers (epithelium, Bowman's layer, and sometimes superficial stroma). SK is done using a surgical blade or diamond burr. Some surgeons use intraoperative mitomycin C 0.02% or amniotic membrane transplantation to improve surgical outcomes. This literature review shows that SK remains an effective method for different indications, including tissue diagnosis, excision of corneal degenerations, dystrophies, scarring, recurrent corneal erosions, and retained corneal foreign body.

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Section: Discussionmentioning

confidence: 96%

Section: Indications For Superficial Keratectomymentioning

confidence: 99%

Superficial Keratectomy: A Review of Literature

et al. 2022

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“…Very-high-frequency(VHF) ultrasound scanning system (Artemis 2; Ultralink LLC), OCT system, and high-frequency ultrasound biomicroscopy have been introduced for the measurement of CCT, corneal flap thickness created by microkeratomes, femtosecond IntraLase, and even detection of post-LASIK pathologies such as Salzmann-like nodular corneal degeneration with good correlation between them. [18][19][20][21][22] Both mechanical microkeratome and femtosecond laser for LASIK flap cutting were reported as effective and safe methods to myopia correction with stable refractive outcomes for both groups. In the concept of flap thickness predictability, the femtosecond laser has benefits over mechanical microkeratome such as better contrast sensitivity function, fewer induced higher order aberrations, and longer tear breakup time.…”

Section: Discussionmentioning

confidence: 99%

Post-LASIK keratectasia in the context of a thicker than intended flap detected by anterior segment optical coherence tomography

Mohammadpour

Khorrami-Nejad

2021

SAGE Open Medical Case Reports

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The corneal flap created in LASIK is responsible for most of its advantages in comparison with surface ablation. However, lamellar dissection of the corneal layers in LASIK can also result in serious complications such as corneal ectasia. A 23-year-old man underwent LASIK for correction of −4.75 −2.00@15 in the right eye and −4.50 −2.00@160 in the left eye with a preoperative thinnest corneal thickness of 518 µm/right eye and 513 µm/left eye in 2009. An intended flap thickness and ablation depth in both eyes were 160 µm and 94 µm, respectively, and subsequently, residual stromal bed thickness was 264 µm/right eye and 259 µm/left eye. Several years after surgery, he was referred for the decreased vision. His corrected-distance visual acuity was 0.50 in both eyes. A scissoring reflex was found in retinoscopy. Orbscan imaging was compatible with keratoconus. Anterior segment optical coherence tomography was performed to measure the LASIK flap. It was much thicker (200 µm) than intended (160 µm), and therefore, the residual stromal bed thickness was much thinner. In summary, keratectasia may develop in cases where thicker than expected flaps result in excessive thinning of the residual stromal bed. The obtained results from this case emphasize and remind the importance of intraoperative measurement of flap thickness and using femtosecond and new criteria for patient selection to avoid post-LASIK keratectasia.

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“…We advise SK with alcohol-assisted delamination or MMC as this combination of treatments decreases the rate of recurrence. [6][7][8] The proximity of the lesions to the LASIK flap margin will require careful dissection to maintain the flap integrity, and we would thoroughly counsel the patient on the intraoperative risks of flap damage. 6 Postoperative vision may still be compromised by post-LASIK and post-superficial keratectomy corneal aberrations, but subsequent PTK would be limited by preexisting low residual stromal bed.…”

Section: Editors' Commentsmentioning

confidence: 99%