Recurrent salzmann’s corneal degeneration

Three keratoplasties were carried out on two patients because of nodular degeneration of the cornea. Progress after keratoplasty could be followed up in one eye for 17 months and in the other two eyes, for 2.5 and 9 years, respectively. The implant with the short follow-up of only 17 months remained glass-clear; nothing abnormal was discovered during the checkups. In the case of the other patient in whom a longer follow-up period was possible, the following findings were evident: (1) a remarkably late epithelial immune response in one eye (after 18 months) with subsequent incomplete reepithelisation and formation of fine, superficial, cloudy opacity (observation period 2.5 years); (2) formation of dense but flat, superficial areas of opacity in the cornea of the other eye (observation period 9 years). These areas may be regarded as a precursor of Salzmann’s corneal degeneration. No difference could be found between the histological findings in the explants and those in a degenerative pannus or an older scar caused by inflammation of the Bowman membrane.