Salzmann's Nodular Corneal Degeneration Clinical Characteristics and Surgical Outcomes

Abstract

To characterize the clinical characteristics and surgical outcomes for Salzmann's nodular corneal degeneration (SNCD). In this retrospective, noncomparative, observational case series, all patients coded with a diagnosis of SNCD between January 1, 1996, and April 30, 2002 were included. Cases whose clinical description did not match the classic description of this disorder were excluded. Clinical characteristics, surgical procedures, and qualitative outcomes were recorded. Among 103 patients diagnosed with SNCD, 93 (152 eyes) met inclusion criteria. Eighty-three patients (89.2%) were women (P < 0.00001), and 59 patients (63.4%) had bilateral disease. A normal age distribution was noted, with a mean age of 54.3 years (median, 53 years; standard deviation = 16.9). Meibomian gland dysfunction was noted in 51 patients (54.8%), contact lens wear in 31 patients (33.3%), peripheral vascularization in 29 patients (31.2%), pterygium in 15 patients (16.1%), keratoconjunctivitis sicca in 9 patients (9.7%), and exposure keratitis in 4 patients (4.3%). Forty-nine eyes (32.2%) of 37 patients (39.8%) required a total of 62 surgical procedures. Impaired vision led to 53 (85.5%) of these procedures and resulted in improved vision in 42 (79.2%) of these cases. Seven eyes (4.6%) underwent surgical intervention for subjective discomfort or contact lens intolerance, and all had improved symptoms at last follow-up. SNCD appears to be a disorder that occurs predominantly in middle-aged women and may be associated with chronic ocular surface inflammation and/or irritation. It is important to diagnose properly because of the good prognosis with medical and surgical therapy.