# Rare Association of Bilateral Central Salzmann Nodular Degeneration and Fuchs Endothelial Dystrophy Managed by DMEK: A Case Report

## TL;DR

A rare case of central Salzmann nodules combined with Fuchs dystrophy was successfully treated with DMEK and other surgeries.

## Contribution

Reports a unique case of bilateral central Salzmann nodules overlapping with Fuchs dystrophy and its surgical management.

## Key findings

- Bilateral central Salzmann nodules were managed with anterior keratectomy and DMEK.
- In vivo confocal microscopy and OCT were used to monitor treatment outcomes.
- Combined surgical approach improved corneal morphology and endothelial function.

## Abstract

Salzmann nodular degeneration is a slowly progressive, rare, degenerative disease of the cornea, usually associated with other ocular pathologies such as dry eye disease, previous ocular surgery, involving the peripheral cornea. We present the surgical management of a rare case of a patient diagnosed with Fuchs endothelial dystrophy where the Salzmann nodules present an unusual bilateral central corneal involvement and overlap the area with the most pronounced endothelial dysfunction. The patient underwent anterior superficial keratectomy, cataract surgery and Descemet membrane endothelial keratoplasty (DMEK). In vivo confocal microscopy and anterior segment optical coherence tomography have been used to monitor the morphological and structural evolution.