Visual acuity outcomes and recurrence rates after superficial keratectomy and phototherapeutic keratectomy for Salzmann nodular degeneration: evidence from the SOURCE multicenter registry.

PURPOSE: Salzmann's nodular degeneration (SND) is a progressive corneal disease leading to decreased vision. Surgery consists of superficial keratectomy (SK) performed with or without mitomycin C (MMC) or phototherapeutic keratectomy (PTK). This study is a summary of clinical outcomes of SND patients who underwent SK, SK + MMC, and PTK.

METHODS

The study used data from the Sight Outcomes Research Collaborative (SOURCE) Data Repository. Data reviewed included patient characteristics, surgery type, and logMAR scores before and after surgery. Clinical outcomes consisted of post-operative best-corrected visual acuity and SND recurrence.

RESULTS

The sample consisted of 5304 patients with SND, 120 (2.26%) of whom underwent unilateral or bilateral surgeries. Surgeries consisted of 123 SK, 8 SK + MMC, and 14 PTK cases with only one instance of recurrence requiring additional surgery (SK group). Separate paired sample t-tests showed that logMAR scores significantly improved from pre-surgery to post-surgery in all groups (p < 0.05 for all three groups). In a multivariate General Estimating Equation analysis accounting for pre-surgery logMAR scores and inter-eye correlation, post-surgery logMAR scores significantly differed between surgical groups (p < 0.05) with the SK group having worse post-surgery logMAR scores (0.25) than both the SK + MMC (0.17) and PTK (0.09) groups.

CONCLUSION

Patients may benefit from MMC during SK.