Corneal Re-Epithelialization following Phototherapeutic Keratectomy for Recurrent Corneal Erosion as in vivo Model of Epithelial Wound Healing

Abstract

Background: This placebo-controlled double-blind study examined the suitability of recording corneal epithelialization after phototherapeutic keratectomy (PTK) as a model of epithelial wound healing. Methods: Eighteen patients with recurrent corneal erosion were randomized into 2 groups, and received PTK with a 7-mm ablation zone. Postoperatively, one group was treated with an ointment containing 5% dexpanthenol and the other with the ointment vehicle without dexpanthenol. The epithelial lesions were recorded by digital slit-lamp photographs with fluorescein staining at fixed intervals until epithelial closure. The size of the epithelial defect was measured, and the average time until epithelial closure was calculated. Reliability of measurements was tested by calculating Cronbach’s α from measurements at the same point in time. Results: Photographs could be taken at all scheduled examinations. The measured size of the epithelial defects showed a high reliability (Cronbach’s α = 0.994). The average time needed for epithelial closure was 57.5 h in the treatment group and 64.8 h in the placebo group (p = 0.177). Conclusions: Planimetric measurement of slit-lamp photographs of standardized epithelial defects is an adequate method for monitoring the progress of corneal epithelial wound healing. Although wounds treated with dexpanthenol showed a slightly shorter average healing time, the difference to the placebo was not significant.