Quality of vision after excimer laser phototherapeutic keratectomy with intraoperative mitomycin-C for Salzmann nodular degeneration.
OBJECTIVE
To assess the effect of excimer laser phototherapeutic keratectomy (PTK) with intraoperative mitomycin-C (MMC) on the quality of vision in patients with Salzmann nodular degeneration (SND).


METHODS
Thirteen eyes of 12 patients were enrolled in the study between December 2010 and March 2012. Uncorrected and best-corrected Snellen distance visual acuities were measured at every visit. Contrast sensitivity and manifest refraction were measured preoperatively, at 1 month and at 3 months. Corneal topography, Galilei dual Scheimpflug imaging, VISX WaveScan, and ultrasound central corneal pachymetry were measured preoperatively and at 3 months after PTK procedure.


RESULTS
Contrast sensitivity was statistically significantly better both at 1 month (P<0.01) and 3 months (P<0.01). Postoperatively, there was 46% increase in eyes with measurable corneal topography, 69% increase in Galilei dual Scheimpflug imaging, and a 77% increase in WaveScan measurements. The third-order (P<0.01) and total corneal higher-order aberrations (HOAs) (P=0.01) were significantly lower postoperatively compared with the preoperative corneal aberrations measured on Galilei dual Scheimpflug imaging.


CONCLUSIONS
Significant improvement in contrast sensitivity and corneal HOAs was seen after PTK for SND. Phototherapeutic keratectomy with MMC can be considered as an effective procedure in the improvement of the quality of vision in patients with SND.
Cornea Service, Wills Eye Institute (J.C.R., C.J.R., A.F.F., P.K.N., K.M.H.), Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA; and Cornea, Anterior Segment and Refractive Surgery Service (J.C.R.), L V Prasad Eye Institute, Hyderabad, India.
Jagadesh C
JC
Reddy
Christopher J
CJ
Rapuano
Anthony F
AF
Felipe
Parveen K
PK
Nagra
Kristin M
KM
Hammersmith
D000328:Adult; D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage*; D015350:Contrast Sensitivity / Q000187:drug effects / Q000502:physiology; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D018903:Photorefractive Keratectomy / Q000379:methods*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology*
D000477:Alkylating Agents; D016685:Mitomycin