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Presentation type	Oral presentation
Title	Visual, Refractive and Tomographic Outcomes After Mitomycin-Free Manual Superficial Keratectomy for Salzmann Nodular Degeneration and Peripheral Hypertrophic Subepithelial Corneal Degeneration: A Retrospective Cohort Study

Purpose	To evaluate visual, refractive, keratometric, aberrometric and densitometric outcomes after manual superficial keratectomy (MSK) without adjuvant mitomycin C (MMC) for Salzmann nodular degeneration (SND) and peripheral hypertrophic subepithelial corneal degeneration (PHSCD).
Methods	Retrospective cohort study of patients treated with MSK without adjuvant MMC at Ghent University Hospital. Outcomes included best-corrected visual acuity (BCVA), refraction and Scheimpflug-based tomography, aberrometry and densitometry (Pentacam). Recurrence rate and complications were recorded.
Results	Pre- and postoperative outcomes were compared in 56 eyes of 38 patients (50 SND, 6 PHSCD) over a median follow-up of 4.6 (mean 13.8) months. BCVA improved from 0.20 to 0.08 logMAR, spherical equivalent from +1.51 to −0.85D, refractive cylinder from −4.56 to −1.24D and corneal astigmatism from 4.31 to 1.40D (all P < 0.001). K1 increased from 38.92 to 42.26 D (P < 0.001), with a smaller increase in K2 (43.25 to 43.67D; P = 0.009). Higher-order root-mean-square aberrations decreased from 2.79 to 1.12µm (P < 0.001) and total root-mean-square aberrations from 7.30 to 3.27µm (P < 0.001). Corneal densitometry did not change significantly in any prespecified zone. Nodular recurrence occurred in one eye (1.8%); secondary pterygia developed in 4 eyes (7.1%); no intraoperative complications occurred.
Conclusion	In this retrospective cohort of eyes with SND or PHSCD, MSK without adjuvant MMC was associated with significant visual, refractive, keratometric and aberrometric improvement. We consider this approach an effective first-line surgical option in symptomatic or visually significant SND and PHSCD.
Conflict of interest	No

Authors 1

Last name	HOUBEN
Initials	I
Department	UZ Gent
City	Gent

Authors 2

Last name	Mourisse
Initials	S
Department	UZ Gent
City	Gent

Authors 3

Last name	Derveaux
Initials	T
Department	UZ Gent
City	Gent

Authors 4

Last name	van Gremberghe
Initials	I
Department	UZ Gent
City	Gent

Authors 5

Last name	Kreps
Initials	E
Department	UZ Gent
City	Gent

Authors 6

Last name	Roels
Initials	D
Department	UZ Gent
City	Gent