Abstract：
OBJECTIVE: To describe the outcomes of five Salzmann\'s Nodular Degeneration (SND) cases treated with a combination of alcohol delamination, superficial keratectomy and amniotic membrane patch with fibrin glue.
METHODS: Five patients affected by SND with significant discomfort and decreased visual acuity were evaluated with refraction, best corrected visual acuity, Break-up time test, corneal topography, Anterior Segment of Optical Coherence Tomography and images of anterior segment with a full slit lamp examination. All the patients underwent alcohol delamination of the corneal epithelium followed by superficial keratectomy to remove the subepithelial nodules. A patch of amniotic membrane was applied to all of them with a ring shape and a banana shape in two patients due to the location of the disease. A bandage contact lens was inserted. The patch was kept in place for 14 days. Another bandage contact lens was inserted for 21 days until the corneal epithelium had completely healed.
RESULTS: The surgical procedure was successful in removing the nodules in all patients. Vision was restored in all cases with a significant regularization of the corneal surface and reduction of ocular discomfort. After a 12-month follow-up, none of the patients showed recurrence of the disease.
CONCLUSIONS: Combining alcohol delamination with superficial keratectomy and amniotic membrane patch with fibrin glue is an effective procedure for the management of SND to regularize the corneal surface and avoid the recurrence of subsequent nodules. This report is the first description of the outcomes of SND cases treated with a combination of the aforementioned techniques.
METHODS: Five patients affected by SND with significant discomfort and decreased visual acuity were evaluated with refraction, best corrected visual acuity, Break-up time test, corneal topography, Anterior Segment of Optical Coherence Tomography and images of anterior segment with a full slit lamp examination. All the patients underwent alcohol delamination of the corneal epithelium followed by superficial keratectomy to remove the subepithelial nodules. A patch of amniotic membrane was applied to all of them with a ring shape and a banana shape in two patients due to the location of the disease. A bandage contact lens was inserted. The patch was kept in place for 14 days. Another bandage contact lens was inserted for 21 days until the corneal epithelium had completely healed.
RESULTS: The surgical procedure was successful in removing the nodules in all patients. Vision was restored in all cases with a significant regularization of the corneal surface and reduction of ocular discomfort. After a 12-month follow-up, none of the patients showed recurrence of the disease.
CONCLUSIONS: Combining alcohol delamination with superficial keratectomy and amniotic membrane patch with fibrin glue is an effective procedure for the management of SND to regularize the corneal surface and avoid the recurrence of subsequent nodules. This report is the first description of the outcomes of SND cases treated with a combination of the aforementioned techniques.
摘要：
目的：描述5例Salzmann结节性变性（SND）患者采用酒精分层联合治疗的结果，浅表角膜切除术和羊膜补片与纤维蛋白胶。
方法：对5例受SND影响且有明显不适和视力下降的患者进行屈光评估，最佳矫正视力，分手时间测试，角膜地形图,光学相干断层扫描的前段和全裂隙灯检查的眼前段图像。所有患者都进行了角膜上皮的酒精分层，然后进行了浅表角膜切除术以去除上皮下结节。由于疾病的位置，在两名患者中以环形和香蕉形对所有羊膜进行了补片。插入绷带接触透镜。将贴片保持在原位14天。插入另一个绷带接触镜21天，直到角膜上皮完全愈合。
结果：手术切除了所有患者的结节。在所有情况下，视力均得到恢复，角膜表面明显规则化，眼部不适减少。经过12个月的随访，没有患者显示疾病复发。
结论：将酒精分层与浅表角膜切削术和羊膜补片与纤维蛋白胶联合使用是治疗SND的有效方法，可以使角膜表面规整并避免随后的结节复发。本报告是对使用上述技术组合治疗的SND病例结果的首次描述。
方法：对5例受SND影响且有明显不适和视力下降的患者进行屈光评估，最佳矫正视力，分手时间测试，角膜地形图,光学相干断层扫描的前段和全裂隙灯检查的眼前段图像。所有患者都进行了角膜上皮的酒精分层，然后进行了浅表角膜切除术以去除上皮下结节。由于疾病的位置，在两名患者中以环形和香蕉形对所有羊膜进行了补片。插入绷带接触透镜。将贴片保持在原位14天。插入另一个绷带接触镜21天，直到角膜上皮完全愈合。
结果：手术切除了所有患者的结节。在所有情况下，视力均得到恢复，角膜表面明显规则化，眼部不适减少。经过12个月的随访，没有患者显示疾病复发。
结论：将酒精分层与浅表角膜切削术和羊膜补片与纤维蛋白胶联合使用是治疗SND的有效方法，可以使角膜表面规整并避免随后的结节复发。本报告是对使用上述技术组合治疗的SND病例结果的首次描述。
