gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Bilateral reversible excessive hyperopia and "optical cornea plana" associated with Salzmann's nodular corneal degeneration

Meeting Abstract

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  • corresponding author K. Gottschalk - Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Erlangen
  • F. E. Kruse - Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Erlangen
  • B. Seitz - Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Erlangen

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 024

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Gottschalk et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




In Salzmann´s nodular corneal degeneration loss of visual acuity is typically caused by subepithelial fibrous material occluding the optical axis. We demonstrate a young patient with major bilateral vision loss despite a clear optical zone.


In this 34-year-old female patient we saw an excessive progression of hyperopia with loss of visual acuity despite prescription of new glasses. The lady complained of progressing contact lens incompatibility and glare. Preoperatively, the refraction was OD +13.5sph-5.0cyl A110°=0.5; OS +15.0sph-8.5cyl A65°=0.4 with normal axial length (OD 22.3mm; OS 22.5 mm) and high irregular keratometric astigmatism (OD 31.0/170° 37.0/50°; OS 29.0/50° 36.5/170°) caused by nodules arranged in the midperiphery of the cornea. Even though the central optical zone was clear we performed a pannectomy and excimer laser phototherapeutic keratectomie (o-PTK).


Reepitheliazation was fast (OD/OS 4 days). Keratometric astigmatism was low and regular after 4 resp. 6 weeks (OD 43,25/0° 44,75/90°; OS 43,75/170°, 44,75/80°). After a follow-up of 4.5 resp. 5.5 months visual acuity was normal (OD sc0.8 cc+1.25-0.5/165°=1.0; OS sc0.8; cc+0.5=1.0) without signs of recurrence.


The circular shaped localization of elevations in Salzmann`s nodular degeneration in the midperiphery cause an "optical cornea plana" with excessive hyperopia and marked irregular astigmatism due to asymmetric pooling of the tear film. Pannectomy and subsequent o-PTK results in a normal refraction and visual acuity due to smoothing of the surface. This intervention may be repeated if necessary.