Centro Diagnostico Oftalmologico Clotilde 2, Milan, Italy.
Oftalmico Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
Eur J Ophthalmol. 2022 Jan;32(1):NP27-NP30. doi: 10.1177/1120672120964691. Epub 2020 Oct 29.
To describe the clinical course of a case of bilateral Salzmann nodular degeneration (SND) treated with superficial keratectomy (SK) followed by intense pulsed light (IPL) for the treatment of coexisting meibomian gland dysfunction (MGD).
A 54-year-old man who presented to us complaining of progressive blurred vision associated with foreign body sensation in both eyes because of SND and coexisting MGD. In view of symptoms and visual acuity (VA) deterioration, bilateral SK was performed. Two months after SK, IPL treatment to the face and expression (MGX) using the E-eye device (E-SWIN, Paris) on days 0, 15, and 45, were performed in both eyes with the aim to avoid recurrence and/or progression of MGD. One year after SK, the patient was asymptomatic and VA was 20/20 in both eyes; however because of worsening of non-invasive tear film break-up time measured on Scheimpflug , IPL and MGX were promptly repeated and scheduled every 6 months.
In our case, IPL was a safe and effective option to control MGD in a patient with SND requiring SK with no observed recurrence of SND 2 years after surgery.
描述 1 例双侧 Salzmann 结节状变性（SND）患者的临床经过，该患者接受了浅层角膜切除术（SK）联合强脉冲光（IPL）治疗并存的睑板腺功能障碍（MGD）。
一名 54 岁男性因 SND 和并存的 MGD 出现进行性视力模糊和双眼异物感，前来就诊。鉴于症状和视力（VA）恶化，对双眼行双侧 SK。SK 后 2 个月，采用 E-eye 设备（E-SWIN，巴黎）对双眼行面部和睑缘（MGX）的 IPL 治疗，于第 0、15 和 45 天进行，目的是避免 MGD 的复发和/或进展。SK 后 1 年，患者无症状，双眼 VA 为 20/20；然而，由于 Scheimpflug 测量的非侵入性泪膜破裂时间恶化，立即重复了 IPL 和 MGX，并安排每 6 个月重复一次。
在我们的病例中，对于需要 SK 的 SND 患者，IPL 是一种安全有效的控制 MGD 的选择，术后 2 年未观察到 SND 复发。
