Epithelial Debridement for Epithelial Basement Membrane Abnormalities Associated with Endothelial Disorders

Abstract

Epithelial basement membrane dystrophy (EBMD) is a corneal condition most commonly observed as a primary disease; less commonly it can also be seen as secondary to endothelial cell dysfunction. Epithelial debridement with or without polishing of the Bowman layer is a safe and effective way of removing the dystrophic basement membrane and promoting a smoother epithelial surface. Indications for debridement include symptoms of recurrent corneal erosions and vision loss attributable to epithelial irregularity. In this article we also present follow-up data on patients for whom we have previously performed epithelial debridement for EBMD in the setting of Fuchs endothelial dystrophy and iridocorneal endothelial syndrome, with favourable visual outcomes. We also present two new cases of EBMD that limited visual acuity after Descemet stripping automated endothelial keratoplasty, who responded successfully to epithelial debridement.