Comparison of Automated Lamellar Keratoplasty and Phototherapeutic Keratectomy for Salzmann Nodular Degeneration

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PurposeThe aim was to compare the outcomes of automated lamellar keratoplasty (ALK) and phototherapeutic keratectomy (PTK) for Salzmann nodular degeneration (SND).MethodsThe records of patients undergoing PTK and ALK for SND at the Cornea services of our tertiary care center from were evaluated retrospectively.ResultsTwenty-one eyes of 21 patients underwent ALK, and 28 eyes of 28 patients underwent PTK. The distribution of age, pachymetry, and pretreatment corrected distance visual acuity (CDVA) was similar in both groups. In the PTK group, the mean ablation was 60.71±14.3 μm, the CDVA improved from 0.09 preoperatively to 0.21 at 6 months. None of the cases demonstrated significant scarring or any evidence of infection. In the ALK group, the mean host cut was 8.5±0.41 mm, and the donor cut was 8.64±0.45 mm, donor thickness 350 μm, and host cut 250 μm. The mean CDVA improved from 0.09 preoperatively to 0.24 at 6 months. At 6 months, 2 patients demonstrated persistently high astigmatism (>8 D), and 2 had graft interface infection. The CDVA at 6 months and the overall change in the CDVA in both the groups was similar (P=0.06 and 0.07, respectively, Mann–Whitney U test). However, the epithelialization time was significantly longer in the ALK group.ConclusionsThe PTK for SND achieved equivalent visual results compared with ALK and may have an important keratoplasty sparing role. The incidence of complications was lesser in PTK in our study cohort.

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