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.