Bilateral Salzmann-like nodular corneal degeneration after laser in situ keratomileusis imaged with anterior segment optical coherence tomography and high-frequency ultrasound biomicroscopy.

Examination of a 34-year-old patient 7 years after laser in situ keratomileusis (LASIK) showed Salzmann-like nodules in both eyes, causing irregular astigmatism and decreased visual acuity. Two new imaging modalities were used to demonstrate the characteristics of this complication. Anterior segment optical coherence tomography (OCT) (Visante) scans showed hyperreflective nodules that varied in thickness from 0.35 mm to 0.56 mm. High-frequency ultrasound biomicroscopy illustrated the destruction of Bowman layer underlying these lesions. Both modalities demonstrated nodules as hyperreflective material covered by an abnormally thin layer of epithelium. Salzmann-like nodular degeneration is a rare but possible cause of decreased visual acuity and irregular astigmatism after LASIK surgery. Ultrasound biomicroscopy and OCT can demonstrate many of the established histopathologic findings in vivo.