International ophthalmology · 2026
Visual, refractive, and tomographic outcomes after mitomycin-free manual superficial keratectomy for Salzmann nodular degeneration and peripheral hypertrophic subepithelial corneal degeneration: a retrospective cohort study.
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Mourisse Sofie, Houben Isabeau, Derveaux Thierry, van Gremberghe Ineke, Kreps Elke O, Roels Dimitri
Аннотация
PURPOSE: To evaluate visual, refractive, keratometric, aberrometric, and densitometric outcomes after manual superficial keratectomy (MSK) without adjuvant mitomycin C (MMC) for Salzmann nodular degeneration (SND) and peripheral hypertrophic subepithelial corneal degeneration (PHSCD).
METHODS: Retrospective cohort study of patients treated with MSK without adjuvant MMC at Ghent University Hospital. Outcomes included best-corrected visual acuity (BCVA), refraction, and Scheimpflug-based tomography, aberrometry, and densitometry (Pentacam HR). Recurrence and complications were recorded throughout follow-up.
RESULTS: Pre- and postoperative outcomes were compared in 56 eyes of 38 patients (50 SND, 6 PHSCD) over a median follow-up of 4.6 (mean 13.8) months (maximum 6.4 years). BCVA improved from 0.20 to 0.08 logMAR, spherical equivalent from + 1.51 to - 0.85 D, refractive cylinder from - 4.56 to - 1.24 D, and corneal astigmatism from 4.31 to 1.40 D (all P < 0.001). K1 increased from 38.92 to 42.26 D (P < 0.001), with a smaller increase in K2 (43.25 to 43.67 D; P = 0.009). Higher-order root-mean-square aberrations decreased from 2.79 to 1.12 µm (P < 0.001) and total root-mean-square aberrations from 7.30 to 3.27 µm (P < 0.001). Corneal densitometry did not change significantly in any prespecified zone. Nodular recurrence occurred in one eye (1.8%); secondary pterygia developed in 4 eyes (7.1%); no intraoperative complications occurred.
CONCLUSIONS: In this retrospective cohort of eyes with SND or PHSCD, MSK without adjuvant MMC was associated with significant visual, refractive, keratometric, and aberrometric improvement. We consider this approach an effective first-line surgical option in symptomatic or visually significant SND and PHSCD.
METHODS: Retrospective cohort study of patients treated with MSK without adjuvant MMC at Ghent University Hospital. Outcomes included best-corrected visual acuity (BCVA), refraction, and Scheimpflug-based tomography, aberrometry, and densitometry (Pentacam HR). Recurrence and complications were recorded throughout follow-up.
RESULTS: Pre- and postoperative outcomes were compared in 56 eyes of 38 patients (50 SND, 6 PHSCD) over a median follow-up of 4.6 (mean 13.8) months (maximum 6.4 years). BCVA improved from 0.20 to 0.08 logMAR, spherical equivalent from + 1.51 to - 0.85 D, refractive cylinder from - 4.56 to - 1.24 D, and corneal astigmatism from 4.31 to 1.40 D (all P < 0.001). K1 increased from 38.92 to 42.26 D (P < 0.001), with a smaller increase in K2 (43.25 to 43.67 D; P = 0.009). Higher-order root-mean-square aberrations decreased from 2.79 to 1.12 µm (P < 0.001) and total root-mean-square aberrations from 7.30 to 3.27 µm (P < 0.001). Corneal densitometry did not change significantly in any prespecified zone. Nodular recurrence occurred in one eye (1.8%); secondary pterygia developed in 4 eyes (7.1%); no intraoperative complications occurred.
CONCLUSIONS: In this retrospective cohort of eyes with SND or PHSCD, MSK without adjuvant MMC was associated with significant visual, refractive, keratometric, and aberrometric improvement. We consider this approach an effective first-line surgical option in symptomatic or visually significant SND and PHSCD.