背景：报道一例角膜穿透性损伤后圆锥角膜后部（PKC）salzmann结节变性（SND）的罕见病例。
方法：一名56岁女性，有反复的光敏感史，异物感,20年前角膜穿透性损伤后的眼泪。患者经裂隙灯显微镜诊断为SND伴PKC，眼前节光学相干断层扫描（OCT），和角膜断层扫描。药物综合治疗（0.1%透明质酸钠滴眼液，重组牛碱性成纤维细胞生长因子滴眼液,和0.1％的氟米龙滴眼液）和绷带隐形眼镜无法缓解最近的发作。进行光疗角膜切除术（PTK）治疗（激光消融深度：15μm；治疗区：7.5mm）以去除结节并使表面光滑。最佳眼镜矫正视力从术前的20/63提高到术后的20/40。随访12个月后无SND复发和角膜扩张。
结论：这是第一个已知的，报道了角膜创伤后SND伴PKC的病例。PTK是具有PKC的SND的安全有效选择。
BACKGROUND: To report an unusual case of salzmann nodular degeneration (SND) in posterior keratoconus (PKC) after a corneal penetrating injury.
METHODS: A 56-year-old woman presented with a history of recurrent light sensitivity, foreign body sensation, and tears after a corneal penetrating injury 20 years ago. The patient was diagnosed with SND accompanying with PKC by slit-lamp microscope, anterior segment optical coherence tomography (OCT), and corneal tomography. A combined therapy of medication (0.1% sodium hyaluronate eye drops, recombinant bovine basic fibroblast growth factor eye drops, and 0.1% fluorometholone eye drops) and bandage contact lens could not relieve the latest episode. A phototherapeutic keratectomy (PTK) treatment (laser ablation depth: 15 μm; treatment zone: 7.5 mm) was performed to remove nodules and smooth the surface. The best spectacle-corrected visual acuity improved from 20/63 preoperatively to 20/40 postoperatively. No SND relapse and corneal ectasia were recorded at follow-up 12 months later.
CONCLUSIONS: This is the first known, reported case of SND accompanying with PKC after corneal trauma. The PTK is a safe and effective option for SND with PKC.
