Recurrent Erosions Research Articles

Epithelial recurrent erosion dystrophy (ERED) from the splice site altering COL17A1 variant c.3156C>T in families of Finnish-Swedish ancestry.

To describe four Finnish families with epithelial recurrent erosion dystrophy (ERED) caused by the pathogenic variant c.3156C>T in collagen type XVII alpha 1 chain gene (COL17A1). Eleven affected and two unaffected individuals underwent clinical ophthalmological examination, anterior segment photography, and corneal topography. Two of them underwent phototherapeutic keratectomy (PTK). Genetic analysis included both next-generation and Sanger sequencing. Specimens from the manual keratectomy of one patient were available for ophthalmic pathologic examination, including immunohistochemistry. The common splice-site altering synonymous variant c.3156C > T, p.(Gly1052=) in COL17A1 was confirmed in 15 individuals with ERED from the four families. Subepithelial corneal scarring grades varied and increased with age, leading to decreased best-corrected visual acuity. PTK improved vision in 58- and 67-year-old individuals without reactivating the disease. The keratectomy specimens showed an uneven epithelium and a spectrum of basement membrane abnormalities, including breaks, fragmentation, multiplication and entrapment within the subepithelial scar, reflecting recurrent erosions. The stromal cells consisted of varying proportions of bland and activated fibroblasts and myofibroblasts, reflecting different ages of scars. The family with the largest number of known affected generations originated from Southern Sweden. The phenotype in the Finnish ERED families is consistent with earlier reports of the c.3156C > T variant, although the severity has varied between reports. The phenotype may be modulated by other genes. This study suggests a likely founder effect of the variant in both Finnish and Swedish populations due to their shared population histories. If vision is compromised, PTK can be considered especially in older patients.

Impact of riverbank erosion on riparian society: a micro-level study along the Ganga-Padma river in Samserganj C.D. Block of Murshidabad District, West Bengal

Th e present paper is a micro-level study aimed at analyzing the impacts of riverbank erosion on riparian society. To fulfi ll the objective, the study has been carried out from two distinctive perspectives; viz. general outlooks and specifi c inquiry. For the general outlook, the Ganga-Padma river in its lower reach downstream of Farakka Barrage in Samserganj Community Development Block has been explored in terms of channel shift ing using multi-dated satellite images. For specifi c inquiry, the eff ects of riverbank erosion on society have been studied using primary data in two selected active bank-erosion-prone cadastral units. Th e results show that recurrent bank erosion has brought a drastic change in the social fabric and caused huge losses rendering riparian inhabitants quite vulnerable, since most of the people in the study units are dependent on land-based economy and belong to poor economic groups. Th ese situations necessitate signifi cant outside assistance. However, there is a signifi cant diff erence (χ2 = 10.85 at p<0.01) in terms of assistance received during the previous year between the two selected study units.

Efficacy of topical insulin for recurrent epithelial corneal erosions.

Topical insulin can promote and accelerate corneal regeneration, even in eyes with serious comorbidities, and offers several benefits over other treatment options. The aim of this study is to evaluate the effect of topical insulin in treatment of recurrent epithelial corneal erosion. Patients with recurrent epithelial erosions were included in a prospective non-randomized hospital-based study, divided into two groups, one of them received persistent epithelial defects (PEDs) conventional treatment and the other received the same treatment with insulin eye drops 4 times/day. All patients were examined carefully by slit lamp. Patients during the 1st, 2nd, 3rd, and 4th weeks as well as after 2months. Demographics, etiology, therapy, comorbidities, and the healing time of PED were performed. Area shows significant improvement after 2weeks (p = 0.006), 2months (p = 0.046), and 3months (p = 0.002) in group II (cornetears gel and topical insulin) as compared to group I (cornetears gel). The recurrence was statistically significant decreased with cornetears gel and topical insulin (group II) by 0.0%, as compared to cornetears gel (group I) by 3 patients (21.4%). Topical insulin can promote corneal reepithelization in recurrent epithelial erosion and decreases recurrence in these cases. Other advantages include excellent tolerance, availability, and cost-effectiveness.

A case report of Hailey-Hailey disease treated with fractional carbon dioxide laser.

Hailey-Hailey disease (HHD), or familial benign pemphigus, is a rare genetic condition characterized by recurrent blisters and erosions with a predilection for intertriginous areas. There is no specific treatment for HHD. Topical and systemic treatments tend to provide temporary remission. Alternative treatment (surgical interventions such as dermabrasion, excision, and laser) has been shown to prolong remission. Considering the risk of complications associated with surgical modalities, laser is often preferred as an alternative for patients failing to respond to first-line therapies. We report a case of recalcitrant HHD successfully treated with a fractional ablative CO2 laser procedure (wavelength of 10600 nm, power of 7-10 W, 2-3 passes) on a 35-year-old female. The patient has a 7-year history of therapy-resistant HHD. A 2-month followup showed substantially resolved lesions, with mild erythema and post-inflammatory hyperpigmentation in treated areas.

MP60-02 ATP2C1 IS A CANDIDATE FOR INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME

You have accessJournal of UrologyCME1 Apr 2023MP60-02 ATP2C1 IS A CANDIDATE FOR INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME Catherine Brownstein, Elicia Estrella, Shira Rockowitz, Marielle Thorne, Pressley Smith, Jeanette Petit, Veronica Zehnder, Richard Yu, Stuart Bauer, Charles Berde, Pankaj Agrawal, Alan Beggs, Louis Kunkel, and Ali Gharavi Catherine BrownsteinCatherine Brownstein More articles by this author , Elicia EstrellaElicia Estrella More articles by this author , Shira RockowitzShira Rockowitz More articles by this author , Marielle ThorneMarielle Thorne More articles by this author , Pressley SmithPressley Smith More articles by this author , Jeanette PetitJeanette Petit More articles by this author , Veronica ZehnderVeronica Zehnder More articles by this author , Richard YuRichard Yu More articles by this author , Stuart BauerStuart Bauer More articles by this author , Charles BerdeCharles Berde More articles by this author , Pankaj AgrawalPankaj Agrawal More articles by this author , Alan BeggsAlan Beggs More articles by this author , Louis KunkelLouis Kunkel More articles by this author , and Ali GharaviAli Gharavi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003318.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic pain disorder causing symptoms of urinary frequency, urgency and bladder discomfort. METHODS: We performed genetic analyses of whole exome sequencing (ES) on a total of 109 individuals with IC/BPS (93 female and 16 male). Each individual had a cystoscopy, physical exam, urinalysis, and completed questionnaires including the O’Leary- Sant for women, and the NIH-CPSI for men. Our study urologist confirmed the IC/BPS diagnosis. Data was analyzed in Codified Genomics for Mendelian variants. SKAT analysis was performed in Genuity Science for a small list of candidate genes, based on the results of the Mendelian analysis. RESULTS: One family had a previously reported SIX5 variant (ENST00000317578.6:c.472G>A, p.Ala158Thr), consistent with Branchiootorenal syndrome 2 (BOR2). A likely pathogenic heterozygous variant in ATP2A2 (ENST00000539276.2:c.235G>A, p.Glu79Lys) was identified in two probands, indicating possible Darier-White disease. Two private heterozygous variants were identified in ATP2C1 (ENST00000393221.4:c.2358A>T, p.Glu786Asp (VUS/Likely Pathogenic) and ENST00000393221.4:c.989C>G, p.Thr330Ser (Likely Pathogenic)), indicative of Hailey-Hailey Disease. SKAT analysis found a trend towards increased burden of rare ATP2C1 variants in the IC/BPS cases vs a control cohort (p=0.03, OR=6.76), though did not survive Bonferroni correction. CONCLUSIONS: Our data suggest that some individuals with IC/BPS may have unrecognized Mendelian syndromes, and ATP2C1, ATP2A2, and SIX5 may be candidate genes for IC/BPS.Impairment of ATP2C1 leads to a dysfunction in the Golgi-associated human secretory pathway Ca2+/Mn2+ ATPase (hSPCA1) that results in recurrent blisters and erosions in intertriginous sites. Studies show that knockdown of SPCA1 results in disruption of Golgi morphology in HeLa cells, and reduction of the amount of Ca2+ stored in the Golgi lumen. The Golgi complex is tightly integrated into the urothelial cellular system, where it is crucial for the health of the blood–urine barrier, mainly through its association with uroplakins. One can hypothesize that mutations of ATP2C1 may also result in a disruption of Golgi morphology in urothelial tissue, impairing the formation of the blood-urine barrier, a hallmark of IC/BPS. Genetically screening individuals with IC/BPS may be useful in diagnosing and treating this painful disorder due to its heterogeneous nature. Source of Funding: This work was funded by NIH 5U54DK104309-07, CDC 1U01DP006634-01-00, P50HD105351, and the Broad Institute BCH Collaborative Grant Award. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e842 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Catherine Brownstein More articles by this author Elicia Estrella More articles by this author Shira Rockowitz More articles by this author Marielle Thorne More articles by this author Pressley Smith More articles by this author Jeanette Petit More articles by this author Veronica Zehnder More articles by this author Richard Yu More articles by this author Stuart Bauer More articles by this author Charles Berde More articles by this author Pankaj Agrawal More articles by this author Alan Beggs More articles by this author Louis Kunkel More articles by this author Ali Gharavi More articles by this author Expand All Advertisement PDF downloadLoading ...

Recurrent Plaque Erosion in a Young Patient

Recurrent Plaque Erosion in a Young Patient

Scour ponds from unusually large tsunamis on a beach-ridge plain in eastern Hokkaido, Japan

Scour ponds from unusually large tsunamis cut across the crest of a beach ridge in Kiritappu marsh, eastern Hokkaido. No fewer than ten of these ponds were imaged by photogrammetry as elongate topographic depressions as large as 5 m by 30 m. Sediments in these ponds are underlain by unconformities that were detected with ground-penetrating radar and observed directly in cores and a slice sample. Sediment deposits in the ponds contain peat and volcanic ash layers, the ages of which suggest that the scouring occurred during tsunamis generated by spatially extensive thrust ruptures along the southern Kuril trench, most recently during the early seventeenth century and its predecessor during the thirteenth–fourteenth century. Some of the ponds appear to have been formed during one tsunami and refreshed during later successors. This evidence of recurrent erosion suggests that the shoreline may retreat as part of earthquake-related cycles of coastal uplift and subsidence.

Clinical and Histopathologic Characteristics and Template of the TGFBI p.(His626Arg) Missense Variant Lattice Corneal Dystrophy.

The aim of this study was to define, following the IC3D template format, the clinical and histopathologic phenotype of the p.(His626Arg) missense variant lattice corneal dystrophy (LCDV-H626R), the most common variant lattice dystrophy, and to record long-term outcome of corneal transplantation in this dystrophy. A database search and a meta-analysis of published data on LCDV-H626R were conducted. A patient diagnosed with LCDV-H626R who underwent bilateral lamellar keratoplasty followed by rekeratoplasty of 1 eye is described, including histopathologic examination of the 3 keratoplasty specimens. One hundred forty-five patients from at least 61 families and 11 countries diagnosed with LCDV-H626R were found. This dystrophy is characterized by recurrent erosions, asymmetric progression, and thick lattice lines that extend to corneal periphery. The median age is 37 (range, 25-59) years at the onset of symptoms, 45 (range, 26-62) years at the time of diagnosis, and 50 (range, 41-78) years at the time of the first keratoplasty, suggesting a median interval from the first symptoms to diagnosis and to keratoplasty of 7 and 12 years, respectively. Clinically unaffected carriers have been of age 6 to 45 years. Central anterior stromal haze and centrally thick, peripherally thinner branching lattice lines in the anterior to midstroma of the cornea were noted preoperatively. Histopathology of the host anterior corneal lamella showed a subepithelial fibrous pannus, a destroyed Bowman layer, and amyloid deposits extending to the deep stroma. In the rekeratoplasty specimen, amyloid localized to scarring along the Bowman membrane and to the margins of the graft. The IC3D-type template for LCDV-H626R should help diagnose and manage variant carriers. The histopathologic spectrum of findings is broader and more nuanced than what has been reported.

Severe sterile inflammatory keratitis associated with recurrent epithelial erosion after small incision lenticule extraction

A 32-year-old man had undergone small incision lenticule extraction (SMILE) that was complicated by intraoperative epithelial detachment in the right eye. Corneal epithelial erosion reoccurred at two and four months after surgery. At the third time of epithelial erosion, slit-lamp examination revealed dense white infiltrates throughout the corneal cap-stromal interface. The patient was initially managed with high-dose topical antibiotics. After the negative culture and Gram staining results from the interface washout, diffuse lamellar keratitis was confirmed and topical steroids were administered. The inflammation resolved, and corneal transparency was achieved after treatment. Timely diagnosis and appropriate treatment are highly critical for prognosis.

Keratitis fugax hereditaria ‐ useful to consider when you have a child with non‐specific corneal findings and symptoms

AbstractPurpose: To report clinical findings in children diagnosed with the autosomal dominant periodic corneal autoinflammation, keratitis fugax hereditaria (KFH, MIM 148200), and to highlight its geographical distribution.Methods: Patients were clinically examined in the Helsinki University Hospital between February 4, 2006, and December 31, 2021, and genetically verified to be carriers of the c.61G > C (rs200154873) variant in NLRP3 by Sanger sequencing. Variant allele frequencies were determined from Genome Aggregation Database (gnomAD) version 2.1.1.Results: The data consist of 10 children from 8 families; 6 boys and 4 girls. Age of onset varied from 3 to 14 (median, 8) years. Patients had typical KFH symptoms: eye pain, photophobia, conjunctival injection, and foreign body sensation. Five patients had corneal oval opacities, and 3 had a mild anterior chamber reaction. Seven were correctly diagnosed at the first visit based on family history. The remaining three children were diagnosed 1, 3, and 8 years after the first visit. Initial diagnoses were anterior uveitis, corneal erosion, and herpetic keratitis. Additionally, epithelial recurrent erosion dystrophy (ERED) or subepithelial mucinous corneal dystrophy (SMCD) had been suspected. Geographically, KFH concentrates to the bilingual Swedish‐speaking coastal areas of Finland. Allele frequencies are 0.014% in Finland, and 0.011% in Sweden, based on gnomAD.Conclusions: Scandinavian ophthalmologists should be aware of the possibility of KFH in case of suspected anterior uveitis, herpetic keratitis, or recurrent corneal erosion in children. Symptoms of paediatric KFH patients are equal to those in adults, but the typical corneal opacity still might recover between the attacks.

Glaucoma Drainage Device Erosions in Patients Receiving Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Retinopathy.

To determine if intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are associated with an increased risk of glaucoma drainage device (GDD) erosions. A retrospective chart review was conducted including patients with diabetic retinopathy and had a GDD implanted at a large academic institution. The rate of GDD erosions was compared between eyes that did or did not receive intravitreal anti-VEGF injections. A subanalysis was also performed the relationship between diabetic macular edema (DME) and intravitreal steroid injections and GDD erosions. A total of 677 eyes from 608 patients was included. A total of 447 eyes received at least one anti-VEGF injection; 230 eyes never received such therapy. Twenty eyes (4.5%) receiving anti-VEGF had at least one erosion event, compared to 7 eyes (3.0%) of patients not receiving anti-VEGF therapy (OR 1.49, p=0.37). Diabetic macular edema was associated with a significantly increased rate of erosion in eyes not receiving anti-VEGF (71.4% versus 31.4%, p=0.034), but not in eyes receiving anti-VEGF (30.0% versus 40.7%, p=0.34). Receiving more than one specific anti-VEGF agent, an increased frequency or total number of anti-VEGF injections, or receiving intravitreal steroids were not associated with an increased risk of erosion (p>0.05). In patients with diabetic retinopathy, the use of anti-VEGF does not result in an increased rate of GDD erosions or recurrent erosions. Further research is needed over a longer follow-up period to determine if longer or more frequent anti-VEGF treatment is a risk factor for recurrent erosions.

The interleukin-6 family in tissues is closely related to the clinical outcomes of oral lichen planus.

We attempted to investigate the role of interleukin-6 (IL-6) family expression in local tissues as it relates to presentations and outcomes in oral lichen planus (OLP), which is a common chronic inflammatory oral disease. A clinical follow-up cohort of OLP patients was established, and a biological sample library was constructed with categorization into erosive type (EOLP) and nonerosive type (NEOLP). Transcriptome sequencing of the lesions was then performed. A multiple regression model was used to explore the differences in IL-6 family expression among patients with different clinical types and clinical outcomes. OLP tissue transcriptome sequencing showed that IL-6 family expression in EOLP increased significantly. It was also found that IL-6 family factors in the OLP recurrent erosion group were significantly increased compared to the persistent nonerosion group. Based on the multiple regression analysis of the OLP clinical cohort, it was found that the increased expression of the IL-6 family was closely related to the clinical types and clinical outcomes of OLP. The high expression of the IL-6 family is closely related to the erosion of local mucosa and poor prognosis of OLP patients. IL-6-related factors may be used as therapeutic targets for OLP patients.

Monitoring bank-line movements of the rivers flowing across the Sundarbans using remote sensing and GIS techniques

Sundarbans is the largest mangrove forest decussated by a network of alluvial rivers upon the Ganges–Brahmaputra–Meghna basin outlined by recurrent bank erosion and accretion leading to channel pattern modification. Standing against various natural disasters, frequent bank-line changes associated with land loss or gain were observed along the main rivers of Sundarbans, causing major changes in river patterns over decades. Monitoring the morphological changes of the river is the main purpose of this research. The present study has undertaken steps to investigate the bank-line shifting of the eight main rivers located within Sundarbans over the past thirty years. The courses of main rivers from Baleswar to Bidyadhari were analyzed using a combined approach of remote sensing and GIS. Landsat images from USGS Earth Explorer were collected, sorted based on almost identical tidal conditions and digitized along the river banks to quantify and observe the dynamic behaviors of the river bank lines. Critical zones were observed in some parts of the river banks which were classified based on large lateral movements along both the left and right banks. The lateral movement of the river banks observed ranging between 160–1600 meters. Analysis has shown that most of the river banks have shifted land-ward which indicates loss of land except Pussur, Arpangasia and few regions of Baleswar River. The collected satellite data provided useful information on river bank configuration as well as changes in river morphology within the Sundarbans.

Efficacy of a Topical Formulation of Henna (Lawsonia Inermis Linnaeus) on the Itch and Wound Healing in Patients With Epidermolysis Bullosa: a Pilot Single-arm Clinical Trial.

IntroductionEpidermolysis bullosa (EB) is a rare inherited genetic skin disorder with severe skin itching and recurrent blisters and erosion. There is no effective and specific therapy for all types of EB.ObjectivesThe aim of this study was to evaluate a topical formulation of henna (Lawsonia inermis Linnaeus) in the management of wounds and the itching sensation in patients with EB.MethodsThis is a pilot single-arm clinical trial. Nine patients with recessive dystrophic EB, with the age range of 5 to 32 years were enrolled in the study. The patients were instructed to apply the topical 1% henna ointment once daily on two erosions and on also two sites with moderate to a severe itching sensation. The total duration of the intervention was 4 weeks with weekly follow-up visits. Patient global impression of improvement, visual analog scale, and clinical global impression of improvement were used for assessing the wound healing process and itching discomfort.ResultsThere was a significant improvement in the skin symptoms of epidermolysis bullosa including skin redness, itching, burning, and local warmness (P < 0.05). Local pain decreased during the study period, but this was not statistically significant (P < 0.19). One patient reported moderate xerosis of skin after continuous usage.ConclusionsIt seems that the topical formulation of henna may be effective in the management of itching, burning, stringing, and cutaneous warmness sensation in patients with EB. Further controlled studies with larger sample sizes are recommended to better evaluate this formulation.

The impact of sensory neuropathy and inflammation on epithelial wound healing in diabetic corneas.

Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes, with several underlying pathophysiological mechanisms, some of which are still uncertain. The cornea is an avascular tissue and sensitive to hyperglycemia, resulting in several diabetic corneal complications including delayed epithelial wound healing, recurrent erosions, neuropathy, loss of sensitivity, and tear film changes. The manifestation of DPN in the cornea is referred to as diabetic neurotrophic keratopathy (DNK). Recent studies have revealed that disturbed epithelial-neural-immune cell interactions are a major cause of DNK. The epithelium is supplied by a dense network of sensory nerve endings and dendritic cell processes, and it secretes growth/neurotrophic factors and cytokines to nourish these neighboring cells. In turn, sensory nerve endings release neuropeptides to suppress inflammation and promote epithelial wound healing, while resident immune cells provide neurotrophic and growth factors to support neuronal and epithelial cells, respectively. Diabetes greatly perturbs these interdependencies, resulting in suppressed epithelial proliferation, sensory neuropathy, and a decreased density of dendritic cells. Clinically, this results in a markedly delayed wound healing and impaired sensory nerve regeneration in response to insult and injury. Current treatments for DPN and DNK largely focus on managing the severe complications of the disease. Cell-based therapies hold promise for providing more effective treatment for diabetic keratopathy and corneal ulcers.

Ab-externo XEN gel stent implantation in primary open-angle glaucoma: 6-month follow-up

Purpose: XEN gel stent (XGS) is one of the minimally invasive glaucoma surgery (MIGS) procedures offering substantial intraocular pressure (IOP)-lowering. We evaluated the efficacy and safety of XGS implantation via an ab externo approach in patients with primary open-angle glaucoma (POAG). We present 13 cases of successful XEN implantation via an ab externo approach in these patients.Study design: Retrospective case series.Methods: This was a retrospective case series involving patients diagnosed with POAG at a tertiary referral centre who underwent XGS implantation between February 2019 and June 2020 for uncontrolled IOP despite maximum topical medications. All patients underwent XGS implantation via an ab externo approach placed at the superotemporal quadrant. The main outcome measure was IOP reduction and number of antiglaucoma medications after XGS implantation, postoperative procedures, and surgical complications.Results: Thirteen eyes of 13 patients were included in the analysis. At the 6-month follow-up, mean IOP reduction was 2.73 ± 3.66 mmHg and mean IOP was 13.8 ± 1.99 mmHg on an average of 1.6 antiglaucoma medications. Complications included transient hypotony and transient IOP spikes requiring needling. Two patients required stent removal due to recurrent conjunctival erosion and stent migration into the anterior chamber.Conclusion: XGS implantation is able to achieve good IOP control with reduced need for antiglaucoma medications after a minimum follow-up of 6 months. Longer follow-up is needed to assess its long-term outcome.

Potential Risks of Corneal Refractive Surgery in Patients with Ectodermal Dysplasia.

Ectodermal dysplasia (ED) involves the aberrant development of at least two ectodermal derivatives, such as skin, teeth, hair, sweat glands, and ocular tissue. The group of over 200 conditions is commonly classified into two major types: hypohidrotic/anhidrotic ED, in which sweat glands are either absent or significantly reduced, and hidrotic ED, in which sweat glands are normal. Ocular manifestations pertinent to patients undergoing corneal vision correction surgery include multifaceted dry eye syndrome, corneal pathology, such as recurrent erosions, scars, neovascularization, and limbal stem cell deficiency, and early-onset cataracts and glaucoma. In this article we discuss the current understanding of ED and offer factors to consider when these patients are seeking corneal refractive surgery.

P-13 Trans-epithelial phototherapeutic keratectomy (PTK) for recurrent corneal erosion syndrome (RCES).

All patients who received PTK treatment for RCES had failed more than one conventional treatment, and were first vetted and approved by the British Columbia public health authority. A retrospective chart review and telephone survey were conducted at the Pacific Laser Eye Centre. Exclusion criteria were ocular co-morbidities potentially affecting treatment efficacy. This study included 593 eyes of 555 patients (46.2% male; 50.9±14.2 years old) who underwent PTK. The leading identified causes of RCES were trauma (45.7%) and anterior basement membrane dystrophy (44.2%). The most common pre-PTK interventions were ocular lubricants (90.9%), hypertonic solutions (77.9%), and bandage contact lenses (50.9%). 36 eyes had undergone surgical interventions such as stromal puncture, epithelial debridement, or diamond burr polishing. Post-PTK, 78% of patients did not require any subsequent therapies, 20% required ongoing drops and 6 patients (1.1%) reported no symptom improvement. All 6 eyes were successfully retreated with PTK between 11.3±14.9 months from initial PTK. All study patients showed no significant differences in best corrected visual acuity pre vs. postoperatively. When compared to other surgical options, PTK is potentially more costly but frequently more effective and has a high safety profile. The third-party public health vetted nature of this study, the high patient satisfaction, and the low recurrence rate of RCES suggest that PTK should be considered at an earlier stage in the management of RCES.

Pedicled Omental Transposition for Recurrent Skin Erosion Following Deep Brain Stimulation Without Hardware Removal

Pedicled Omental Transposition for Recurrent Skin Erosion Following Deep Brain Stimulation Without Hardware Removal

Transepithelial phototherapeutic keratectomy for post-traumatic recurrent corneal erosions.

Purpose:To evaluate the outcomes of transepithelial phototherapeutic keratectomy (transepithelial PTK) for treatment of posttraumatic recurrent corneal erosions.Methods:Twenty-four eyes of 22 patients with posttraumatic recurrent corneal erosions who were treated with transepithelial PTK from April 2018 to July 2020 were included in this retrospective study. The rates of recurrent erosions and complications were evaluated during the follow-up after surgery. Visual acuity and refraction were recorded preoperatively and 1 year after surgery. Total corneal astigmatism, total corneal irregular astigmatism, and total corneal spherical aberrations were recorded using corneal tomography preoperatively and 1 year after surgery.Results:Mean postoperative follow-up was 13 months (range: 12–32 months). None of the patients suffered from any complications or further erosions. Uncorrected distance visual acuity, best-corrected distance visual acuity, spherical equivalent, and cylinder remained stable at 1-year postoperatively compared with the baseline (P = 0.214, P = 0.461, P = 0.084, and P = 0.879, respectively). Moreover, there was no significant difference in total corneal astigmatism, total corneal irregular astigmatism, and total corneal spherical aberrations between baseline and 1-year postoperative visit (P = 0.938, P = 0.136, and P = 0.981, respectively)Conclusion:Transepithelial PTK was an effective treatment for patients with posttraumatic recurrent corneal erosions.