Salzmann nodular degeneration associated with epithelial ingrowth after LASIK treated with superficial keratectomy

A 41-year-old woman who underwent uncomplicated LASIK and two subsequent flap lifts for epithelial ingrowth of the right eye became progressively symptomatic with blurred vision, photophobia and foreign body sensation over the ensuing 5 years. Clinical examination of the right eye demonstrated extensive epithelial ingrowth around the flap periphery with overlying Salzmann nodules in the same distribution. Similar findings were not present in the left eye. Anterior segment optical coherence tomography demonstrated subclinical flap elevation in the areas of epithelial ingrowth, which may have predisposed to nodule development due to a dellen effect. The patient underwent superficial keratectomy with significant improvement of her symptoms.