[Salzmann's nodular degeneration on a corneal graft 20 years after penetrating keratoplasty for keratoconus].

INTRODUCTION

We report a unique case of a young patient who underwent penetrating keratoplasty for keratoconus 20 years previously and presented in our department with visual deterioration due to Salzmann's nodular degeneration (SND) on the corneal graft, induced probably by underlying recurrent herpetic (HSV) keratitis. The patient was treated with phototherapeutic keratectomy (PTK) and despite the low endothelial density of the corneal graft, visual acuity was sufficiently restored.

CONCLUSION

Treatment with PTK is a promising therapeutic option in SND to avoid repeat penetrating keratoplasty, even if the prognosis for the corneal graft is endangered by several risk factors (age of the graft, low endothelial density, subclinical recurrent HSV infection).