Removal of Salzmann’s Nodule and Amniotic Membrane Placement

Abstract

Salzmann’s nodular degeneration is a progressive degenerative disease of the cornea that is characterized by the multiple nodular bluish-gray opacities with various number and size (Z Augenheilkd 57:92–99, 1925). The indications for surgery include reduced vision due to encroachment on the visual axis, irregular astigmatism, chronic irritation, and persistent symptoms despite conventional medical therapy (Cornea 29:1469, 2010; Cornea 24:772–777, 2005). Numerous surgical techniques, including superficial keratectomy and superficial keratectomy followed by phototherapeutic keratectomy and keratoplasty depending on the thickness of the involved cornea, have been described (Ocul Surf 14:20–30, 2016). This chapter is focused on the key surgical techniques that are used based on placement of self-retained cryopreserved amniotic membrane (PROKERA^®, Bio-Tissue, Miami, FL) following superficial keratectomy to prevent inflammation, scarring and vascularization so as to achieve a favorable surgical outcome without the use of mitomycin C.