Salzmann Knots

So-called Salzmann corneal degeneration produces whitish-gray nodules on the cornea. These develop over months to years and often affect both eyes. The cause has not yet been clarified, with inflammatory reactions, corneal interventions and hereditary factors playing a role. Those affected often also have inflammation in the eyelid margins, allergies, use of contact lenses or inflammatory system diseases.

Reasons for surgical removal

• The cornea becomes irregular, which affects vision
• The knot expands towards the optical axis, i.e. to the center of the cornea
• Body sensation and tear film problems occur
• The earlier a Salzmann knot is removed, the lower is the risk that it will recur

operation process

During removal, the top layer of cornea is removed with a fine knife. The knot is fixed with tweezers and removed directly below the Bauman membrane on the stroma. If the Bauman membrane under the Salzmann node is no longer intact and the corneal surface is therefore irregular, regularization can be carried out with the excimer laser in a further step.

risks

After the Salzmann nodule has been removed, a contact lens containing antibiotics is inserted. This minimizes the risk of infections and accelerates the healing of the top layer of the cornea (epithelium). Tears, burning, foreign body sensation, blinding sensitivity and reduced visual acuity usually occur for the first few days after treatment. Vision usually improves after a few days to two weeks, depending on the size of the Salzmann nodule.

The return of the Salzmann nodule occurs in up to 20% of cases > a new removal is necessary, less often after a few months, more often after a few years. By using mitomycin C, the probability of the Salzmann nodule forming again can be reduced. Mitomycin C is a so-called cytostatic agent for excessive cell growth. However, in very rare cases, this medication may cause corneal tissue to melt > this may require further treatment

Corneal infections are rare because local antibiotics are used prophylactically > can be treated with additional antibiotic agents

Slowed healing is very rare > can be treated with bandage contact lenses

FAQs — common questions

How long does the procedure take?

10-20 minutes

Is an anesthetic required?

No, numbing eye drops are sufficient as only the cornea is treated.

When can I get back to work after the procedure?

Depending on the location and extent of the Salzmann node, you can usually return to work after just a few days. For more extensive salt mannoid changes, healing can take up to two weeks.

Is the procedure covered by health insurance?

Yes

How can I reduce the risk of the Salzmann knot recurring?

• Regularly moisturizing the cornea
• Eyelid hygiene
• early removal

How do I notice that the node has returned?

• feeling of sand in the eyes
• Vision becomes blurred
• Contact lenses don't fit properly anymore
• Half-yearly ophthalmological checkups

What happens if I decide not to have a treatment?

The Salzmann node can increase in size and spread out onto the optical axis, which severely impairs vision. Healing then takes significantly longer and the risk of the lump coming back is increased. In individual cases, the Salzmann nodule also progresses into the underlying corneal tissue, which makes removal significantly more difficult.