Treatment Of Recurrent Corneal Erosions Research Articles

Safety and Efficacy of the Phototherapeutic Keratectomy for Treatment of Recurrent Corneal Erosions: A Systematic Review and Meta-Analysis

Background: Phototherapeutic keratectomy (PTK) has been increasingly used to treat severe recurrent corneal erosion syndrome (RCES) patients who do not respond to other treatments. However, the efficacy and complication of each study are currently uncertain due to varying rates. Objectives: The objective of this study was to investigate the safety and efficacy of the PTK for recurrent corneal erosions. Methods: This article performed a systematic literature research in Cochrane, Embase, PubMed, Scopus, and the Web of Science for the literature on PTK treatment of RCES until December 20, 2022. The extracted data including recurrence rate and the adverse event rate were used for meta-analysis. Results: The recurrence rate was 18% (95% CI, 13%–24%) (129/700 eyes). Subgroup analysis showed that the RCE recurrence was 17% (95% CI, 9%–24%) after trauma and 22% (95% CI, 11%–32%) in the corneal dystrophy group. Treatment-related adverse events included subepithelial haze, hyperopic shift, and decrease of the best spectacle-corrected visual acuity. In this study, the incidence of these events was 13% (95% CI, 6%–21%), 20% (95% CI, 11%–28%), and 11% (95% CI, 5%–16%), respectively. Conclusions: PTK represented a valuable treatment option for patients with recurrent corneal erosions, especially those with traumatic injuries, which had minimal side effects.

Experience of Using Corneal Epithelium Protector Gel for the Treatment of Corneal Erosion for a Patient after Radial Keratotomy

Currently, one of the actual problems of pharmacotherapy is the treatment of recurrent corneal erosions. Traumatic and postoperative damage to the cornea can disrupt the connection between the basement membrane and the epithelium. One type of such predisposing factors that disrupt the connection between the epithelium and the basement membrane is a previously performed anterior radial keratotomy. This article describes a clinical case using off-label “Protector of corneal epithelial SPHERO®oko gel” within the complex treatment of traumatic corneal erosion for a patient after radial keratotomy. A conservative treatment includes applying 5 % dexpanthenol gel, 0.05 % picloxidine solution, a tear substitute and Corneal Epithelium Protector (BIOMIR Service, Russia) 4 times a day until the erosion was closed and then again during 2 weeks. On the 14th day complete epithelization of the cornea was achieved. Within 2 weeks the condition remained stable. Protector of corneal epithelial showed its effectiveness in complex treatment of traumatic corneal erosion for a patient after radial keratotomy.

Phototherapeutic keratectomy versus epithelial debridement combined with anterior stromal puncture or diamond burr for recurrent corneal erosions

ObjectiveTo compare outcomes of phototherapeutic keratectomy (PTK) versus epithelial debridement combined with anterior stromal puncture (ASP) or diamond burr for the treatment of recurrent corneal erosions (RCES) in a large tertiary centre. MethodsPatients with a diagnosis of RCES secondary to trauma or epithelial basement membrane dystrophy who underwent a surgical procedure between 2009 and 2019 were included in the study. The following data were collected: demographics, ocular history, prior medical treatment, ocular surgeries, intervention, complete epithelialization at postoperative week 1, recurrences, and complications. Recurrence was defined as either an objective finding of a corneal epithelial defect or symptoms suggestive of recurrent epithelial erosion on history. Recurrence rate and time to epithelialization were compared between groups. ResultsA total of 97 eyes (73 patients) were included in the study. Mean patient age was 51 ± 16.1 years, and mean follow-up was 474 days. RCES was secondary to epithelial basement membrane dystrophy in 80% (n = 78 of 97), trauma (15%, n = 15 of 97), or idiopathic (4%, n = 4 of 97). Epithelial debridement with ASP was performed in 34 eyes (35%), diamond burr in 33 eyes (33%), and PTK in 30 eyes (31%). Compared with epithelial debridement with ASP (recurrence 29.4%), the recurrence rate was significantly lower for both the diamond burr (9.1%, p = 0.031) and PTK groups (10%, p = 0.048). The diamond burr and PTK groups also had a significantly higher rate of complete epithelialization at 1 week (p < 0.05). ConclusionCompared with epithelial debridement with ASP, diamond burr and PTK have significantly lower rates of recurrence and time to epithelialization and may be considered first for surgical management of RCES.

Comprehensive Approach to the Management of Patients with Recurrent Corneal Erosions

In the Russian literature, there are only a few works that summarize their own experience in the treatment of recurrent corneal erosion (RCE) in a limited group of patients, which actualizes further research in this direction.Objective: to develop and evaluate the clinical effectiveness of an integrated approach to the management of patients with RCE.Patients and methods. 69 patients (69 eyes) with RCE and a disease duration of at least two years, who were divided into 3 groups according to the frequency of relapses: group 1 (12 people) — episodes of RCE no more than 2–4 times a year; Group 2 (19 people) — RCE episodes no more than once a month; Group 3 (38 people) — RCE episodes more than 2 times a month. All patients were cured by pharmacological support, if conservative therapy was ineffective (1 relapse during treatment within 1 month), phototherapeutic keratectomy (PTK) was performed with the application of a bandage contact lens and the appointment of pathogenetically-oriented treatment for up to 1 year. The average follow-up period was 28.6 ± 6.1 months.Results and discussion. In group 1, during the entire period of observation, RCE was compensated by the therapy, in the other groups, the effectiveness was lower, which in 41 (59.4 %) cases required the implementation of PTK. There were no relapses of corneal erosion after PTK with subsequent pathogenetically-oriented therapy, including heparin-containing medications in instillation (CHYLOPARIN-KOMOD®) and ointment forms (PARIN-POS®) for 1 year.Conclusion. The high effectiveness of PTK with subsequent pathogenetically-oriented pharmacological support may be the basis for a broader recommendation of this method in patients with RCE and a relapse rate of more than 1 time a month.

Intraoperative Swept-Source OCT-Based Corneal Topography for Measurement and Analysis of Stromal Surface After Epithelial Removal.

To assess intraoperative stromal topography measurements using swept-source optical coherence tomography (OCT)-based topography/tomography after epithelial removal and to analyze the epithelial contribution to the corneal topography and optics. This was a prospective series of 22 eyes of 19 patients referred to receive phototherapeutic keratotomy (PTK) for treatment of recurrent corneal erosion and a control group of 22 virgin eyes. Swept-source OCT corneal topography/tomography was obtained immediately before and immediately after mechanical deepithelialization before PTK. Epithelial thickness maps were obtained before the surgery using spectral-domain OCT in the control group and as a reference in the group with anterior basement membrane dystrophy. Topographic and optical characteristics, including the curvature, astigmatism, asphericity, and higher order aberrations of the cornea before and after deepithelialization were compared, and their differences correlated with the measurements derived from the epithelial thickness maps. Stromal topography measurements after deepithelialization were easily obtained and showed excellent repeatability. Assessment of corneal edema induced by deepithelialization revealed that it did not significantly affect the measured parameters. The stromal surface was steeper by 1.28 diopters, had higher with-the-rule astigmatism by 0.41 diopters, was more prolate, and had more higher order aberrations compared to the intact epithelialized corneal surface. These differences correlated well with the parameters derived from epithelial thickness maps. Measurement of stromal topography using swept-source OCT immediately after mechanical deepithelialization may be a viable method in therapeutic refractive surgery, where stromal topography-guided ablation is needed. A significant epithelial contribution to anterior corneal topography and optics was confirmed. [J Refract Surg. 2021;37(7):484-492.].

Gelatin Methacrylate as an Enzyme-Controlled Release Vehicle of Hyaluronic Acid for the Treatment of Recurrent Corneal Erosion.

Recurrent corneal erosion (RCE) is a condition where the superficial corneal epithelial cells sporadically shed because of poor attachment to the underlying basement membrane, resulting in pain and discomfort. RCE-afflicted corneas exhibit elevated biological factors and enzymes, such as matrix metalloproteinase (MMP)-9. Soft bandage contact lenses (BCLs) are a commonly recommended treatment as they permit continued vision during recovery. However, they do not outperform alternative treatments as they currently lack active ingredients for ocular surface repair. Development of BCLs with a sustained release of active ingredients to promote RCE wound healing over an extended period of time would be clinically valuable. We fabricated gelatin methacrylate (GelMA) hydrogels with MMP-9-triggered controlled release for further BCL development. GelMA disks were characterized to determine the optimal concentration and methacrylation degree for sustained release in the presence of MMP-9. The chosen active ingredient, 60 kDa hyaluronic acid (HA), was verified to promote wound healing in rabbit corneal epithelial cell and human corneal epithelial cell wound assays. The active ingredient was loaded into GelMA hydrogels, and the bioavailability of the vehicle was determined. The GelMA hydrogels revealed a tunable profile for diffusion and enzyme-mediated controlled release of a model molecule. The 60 kDa HA-loaded GelMA disks showed improvement in wound healing at HA loadings of 150 and 250 μg by improving the wound healing rates by 28% (68.7% wound closure) and 26% (67.9% wound closure), respectively, compared to the control (50.5% wound closure) at 24 h. The HA-loaded GelMA disks with 150 and 250 μg HA also exhibited shortened wound closure time of 75 h compared to >147 h with a bolus daily delivery of HA for wound closure. Overall, we demonstrated that the fabricated GelMA hydrogels offered an enzyme-triggered option as a sustained release material for future RCE treatments.

Alcohol-assisted epithelial debridement for treatment of recurrent corneal erosion: a case series

Purpose: Recurrent corneal erosion is characterized by recurrent episodes of spontaneous breakdown of the corneal epithelium. Alcohol delamination of the corneal epithelium has a high success rate, but the procedure requires the use of an operating microscope in an operating theater. We present a case series of alcohol assisted epithelial debridement in the clinic setting. Methods: Records of eight consecutive patients aged >18 years who presented to a private ophthalmology practice clinic in Hong Kong between October 2012 and March 2018 with recurrent corneal erosion that did not respond well to conservative or surgical management with persistent symptoms of >3 months were retrospectively reviewed. 75% alcohol was applied directly to the site of abnormal epithelium under slit lamp, followed by debridement of the epithelium using a surgical sponge. A bandage contact lens was then inserted. Patients were followed up until complete healing of the epithelial defect. Results: All eight patients achieved complete healing of the epithelial defect within 2 weeks with no major complication or recurrence. Conclusion: Alcohol-assisted epithelial debridement is simple, safe, and effective for the treatment of recurrent corneal erosion. It can be performed in a clinic setting under slit lamp.

Autologous Platelet-rich Plasma Eye Drops in the Treatment of Recurrent Corneal Erosions.

PurposeTo evaluate the effect of platelet-rich plasma (PRP) eye drops in the treatment of recurrent corneal erosions (RCE).MethodsA total of 47 eyes were included in this retrospective study. Clinical records of 20 consecutive patients with RCE who had been treated with conventional lubricant eye drops (conventional treatment group) from June 2006 to December 2008 and 27 consecutive patients treated with autologous PRP eye drops in addition to lubricant eye drops (PRP eye drops treated group) from January 2009 to September 2014 were reviewed. Major and minor recurrences were recorded and compared between two groups.ResultsThis study included 31 men and 16 women. The mean age was 44.5 ± 14.5 years (range, 19 to 86 years), and the mean follow-up duration was 14.9 ± 14.4 months (range, 6 to 64 months). Of the 27 cases in the PRP eye drops treated group, there were seven major recurrences in six eyes (22.2%) and ten minor recurrences in seven eyes (25.9%). In contrast, 16 eyes (80.0%) from the 20 patients in the conventional lubricant eye drops treated group had major recurrences, and all patients in this group reported minor recurrences. The mean frequency of recurrence was 0.06 ± 0.08 per month in the PRP eye drops treated group and 0.39 ± 0.24 per month in the conventional treatment group (p = 0.003). No side effects were noted in any of the patients over the follow-up period.ConclusionsThe use of PRP eye drops for the treatment of RCE was shown to be effective in reducing the recurrence rate without any significant complications.

Comparison of Nd:YAG Laser versus Conservative Management in the Treatment of Recurrent Corneal Erosion

Purpose: To compare the treatment effects of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser and conservative management in treatment of recurrent corneal erosion. Methods: Twenty-three eyes that received Nd:YAG laser treatment and 24 eyes that underwent conservative management including hyperosmotic agent were retrospectively reviewed for the rate and frequency of recurrence, presentation, time to recurrence, final visual acuity and complications. Results: The rate of recurrence in eyes treated with Nd:YAG laser was 56.5% and that in eyes with conservative management was 50.0%. The difference was not statistically significant (p = 0.654). However, 10 of 12 eyes that recurred after conservative treatment presented with macroform erosion at the time of recurrence, whereas 5 of 13 eyes that recurred after Nd:YAG laser had an accompanying epithelial defect (p = 0.041). After the Nd:YAG laser treatment or conservative treatment, 64.1% and 60.5% of the eyes, respectively, remained free from recurrence 1 year after treatment, however the success rate decreased over time (p = 0.649). The final visual acuity in the group that received Nd;YAG laser treatment was 0.05 ± 0.06 log MAR and 0.09 ± 0.08 log MAR (p = 0.649) in the group that received conservative management. None of the patients in either group experienced complications of corneal scarring. Conclusions: The difference in the recurrence rates between Nd:YAG laser treatment and conservative treatment were not statistically different, however, the severity of recurred episodes were milder in the eyes that received Nd:YAG laser treatment. J Korean Ophthalmol Soc 2015;56(5):687-693

Structural Manipulation of Microcone Arrays for Microsurgical Modification of Ophthalmic Tissues

The purpose of this study was to utilize controllable fiber-drawing techniques in order to fabricate glass microcone arrays for use in office-based optical surgery instruments. The cone spacing is controlled via the drawing process while an etching process controls the cone height-to-base ratio. The device viability was tested by imprinting, and subsequent staining, of low-density polyethylene and porcine corneas, resulting in a consistent patterned structure of micron-sized perforations. After imprint, the device was examined and no evidence of microcone fracture or overpenetration was present during the course of these experiments. This research promises to lead to advances in optical surgery for the treatment of recurrent corneal erosions, providing quicker, safer, and more cost-effective procedures with decreased risk of vision loss and scarring associated with current procedures such as anterior stromal puncture. The ease of procedure and micron-sized incisions could potentially replace current techniques and provide a viable treatment alternative for recurrent corneal erosions in the visual axis.

Epithelial debridement with diamond burr superficial keratectomy for the treatment of recurrent corneal erosion

Epithelial debridement with diamond burr superficial keratectomy for the treatment of recurrent corneal erosion

Autologous serum eyedrops versus systemic doxycycline and topical corticosteroids in the treatment of recurrent corneal erosion

PurposeThe aim of the study was to evaluate the efficacy of autologous serum eyedrops for the treatment of recurrent corneal erosion when compared with systemic doxycycline and topical steroids.Patients and methodsIn this prospective study, 27 eyes of 20 patients with recurrent corneal erosion were divided into two groups. In group A (14 eyes), the patients were treated with autologous serum eyedrops and in group B (13 eyes), the patients were treated with systemic doxycycline and topical steroids. In group A, autologous serum eyedrops were administered five times daily. Serum eyedrops were prepared by obtaining 50 ml of patient's blood and allowing it to clot, and the serum was obtained by centrifugation for 15 min. Detailed informed consent was obtained from all patients before the study. Patients in group B received oral doxycycline (50 mg) twice daily and topical fluoromethalone (0.1%) three times daily. The two groups were followed up for 6 months and were compared for the signs of relapse or recurrence of corneal symptoms and for any ocular complications.ResultsThe study included 27 eyes of 20 patients (age range: 10-45 years). Eleven eyes in group A (78.5%) had complete healing of erosions with no relapse of the disease during the follow-up period. Two eyes (14.3%) presented with a recurrence after the end of the treatment and one eye (7.1%) failed to heal. No ocular complications were detected during the follow-up. In group B, eight eyes (61.5%) showed complete healing with no relapse of the disease during the follow-up period and one eye (7.7%) failed to heal. Four eyes (30.7%) presented with a recurrence after the end of the treatment, with a significant difference compared with group A (P = 0.02). One patient in group B showed an increase in intraocular pressure in the follow-up period.ConclusionThis study suggests that the treatment of recurrent corneal erosion with autologous serum eyedrops gives the same results as with the treatment with systemic doxycycline and topical steroids, with low recurrence rate and less complication.

Interventions for recurrent corneal erosions

Recurrent corneal erosion is a common cause of disabling ocular symptoms and predisposes the cornea to infection. It may follow corneal trauma. Measures to prevent the development of recurrent corneal erosion following corneal trauma have not been firmly established. Once recurrent corneal erosion develops simple medical therapy (standard treatment) may lead to resolution of the episode. However, some patients continue to suffer when such therapy fails and once resolved further episodes of recurrent erosion may occur. A number of treatment and prophylactic options are then available but there is no agreement as to the best option. To assess the effectiveness and safety of prophylactic and treatment regimens for recurrent corneal erosion. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 6), MEDLINE (January 1946 to June 2012), EMBASE (January 1980 to June 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to June 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 13 June 2012. We also contacted researchers in the field. We included randomised and quasi-randomised trials that compared a prophylactic or treatment regimen with another prophylaxis/treatment or no prophylaxis/treatment for patients with recurrent corneal erosion. Two authors independently extracted data and assessed trial quality. We contacted study authors for additional information. Seven randomised and one quasi-randomised controlled trial were included in the review. The trials were heterogenous and of poor quality. Safety data presented were incomplete. For the treatment of recurrent corneal erosion, a single-centre trial in the UK with 30 participants showed that oral tetracycline 250 mg twice daily for 12 weeks or topical prednisolone 0.5% four times daily for one week, or both, in addition to standard treatment, accelerated healing rates and improved symptoms. A single-centre trial in Sweden with 56 participants showed that excimer laser ablation in addition to mechanical debridement may reduce the number of erosions and improve symptoms. Furthermore, in a single-centre trial in Germany with 100 participants, transepithelial technique for excimer laser ablation had the same efficacy as the traditional subepithelial excimer laser technique but caused less pain. In a small study of 24 participants in UK, therapeutic contact lens wear was inferior to lubricant drops and ointment in abolishing the symptoms of recurrent corneal erosion and had a high complication rate, although the contact lenses used were the older generation with low oxygen permeability. A recent study in Hong Kong with 48 participants found diamond burr polishing to reduce episodes of recurrent corneal erosion. For prophylaxis of further episodes of recurrent corneal erosion, there was no difference in the occurrence of objective signs of recurrent erosion between hypertonic saline ointment versus tetracycline ointment or lubricating ointment in a small Japanese study with 26 participants. Also, in a single-centre study in the UK with 117 participants, there was no difference in symptom improvement between hypertonic saline versus paraffin ointment when used for prophylaxis. In a UK study with 42 participants, lubricating ointment at night in addition to standard treatment to prevent recurrence following traumatic corneal abrasion (erosion) caused by fingernail injury led to increased symptoms of recurrent corneal erosion compared to standard therapy alone. Well-designed, masked, randomised controlled trials using standardised methods are needed to establish the benefits of new and existing prophylactic and treatment regimes for recurrent corneal erosion. International consensus is also needed to progress research efforts towards evaluation of the major effective treatments for recurrent corneal erosions.

Application of Umbilical Cord Serum Eyedrops for Recurrent Corneal Erosions

To investigate the efficacy of umbilical cord serum eyedrops for the treatment of patients with recurrent corneal erosions. Thirty-five eyes of 35 patients with recurrent corneal erosions were studied. Eighteen eyes were treated with 20% umbilical cord serum eyedrops in addition to artificial tears (group A), and 17 eyes received artificial tears only (group B). Frequency of recurrence of corneal erosions was compared between the 2 groups. The study included 17 male and 18 female patients. Mean age was 46.6 ± 13.4 years, and mean follow-up duration was 14.7 ± 2.5 months. No significant differences in age, sex, and follow-up duration were observed between the 2 groups. In group A, recurrence occurred 2 times in 3 eyes, 1 time in 3 eyes, and did not occur in 12 eyes. In group B, recurrence occurred 5 times in 1 eye, 3 times in 5 eyes, 2 times in 8 eyes, 1 time in 2 eyes, and did not occur in 1 eye. The mean frequency of recurrence was 0.50 ± 0.79 (0.04 ± 0.07 per month) in group A and 2.24 ± 1.09 (0.15 ± 0.08 per month) in group B (P < 0.01). No significant complications associated with serum use were observed. In the treatment of recurrent corneal erosions, umbilical cord serum eyedrops may be effective in reducing the number of recurrences.

Treatment of Recurrent Corneal Erosion by Extended-wear Bandage Contact Lens

To assess the efficacy of using a bandage contact lens (BCL) for 3 months for recurrent corneal erosions (RCE) to facilitate epithelial adhesion. Retrospective study of patients presented to the Casey Eye Institute (Portland, OR) with RCE after failing at least 6 weeks of medical lubrication therapy. Subjects were treated with an extended-wear BCL for 3 months and then followed for approximately 1 year. The main outcome measure was recurrence of RCE. Best-corrected visual acuity was measured before and after BCL therapy. From the 12 patients studied, 9 (75%) had no recurrence of RCE after approximately 1 year of follow-up. Three subjects had subjective complaints of recurrent erosion during the follow-up period with 1 of these 3 subjects having objective findings of a recurrent erosion. Three-month BCL treatment is a safe and effective medical therapy with a relatively low recurrence rate of RCE.

Efficacy of Different Excimer Laser Techniques in the Management of Recurrent Corneal Erosions

To investigate the efficacy of two excimer laser techniques for recurrent corneal erosions (RCEs). Of 100 patients with RCEs not responding to common treatments, 50 received transepithelial (group 1) and 50 received subepithelial (group 2) treatment of 20 pulses of a 193-nm excimer laser (170 J/cm(2)). Postoperative follow-up occurred at 4 and 52 weeks. Outcome measures were frequency of RCEs, haze formation, and refractive changes. At first follow-up, 7 patients (14%) in each group displayed recurrence. At second follow-up, 12 patients in group 1 (24%) and 10 patients in group 2 (20%) had RCE. Follow-up recurrence risk was 6% to 27% in both groups at 4 weeks and 13% to 38% in group 1 and 10% to 34% in group 2 at 52 weeks. The spherical equivalent remained unaffected in group 1, but a statistically significant change was observed in group 2. Excimer laser treatment (transepithelial and subepithelial) of RCEs can be performed successfully on the intact epithelium without adjunct therapy or pain. The transepithelial technique is a simple and relatively painless way to reduce the rate of RCE and is equivalent to the well-established subepithelial treatment.

Alcohol delamination in the treatment of recurrent corneal erosion: an electron microscopic study

AimTo investigate by electron microscopy the plane of separation of the epithelial sheet from its substratum in the procedure of alcohol delamination (ALD) in patients with recurrent corneal erosion syndrome.MethodsTen...

Dystrophia Helsinglandica: a new type of hereditary corneal recurrent erosions with late subepithelial fibrosis

To describe the phenotype of an autosomal-dominant corneal dystrophy with an early onset of recurrent corneal erosions and development of subepithelial fibrosis in the cornea, and also to exclude genetic linkage to known corneal dystrophies with autosomal-dominant inheritance and clinical resemblance. We describe the medical history and clinical findings in individuals from a seven-generation family with recurrent corneal erosions. A total of 43 individuals were evaluated by ophthalmological examination. Genomic DNA was prepared from peripheral blood and polymorphic microsatellite markers were analysed to study haplotypes surrounding genes causing corneal dystrophies with similar phenotypes. Erosive symptoms usually lasted for between 1 and 10 days. By the age of 7 almost all of the affected individuals suffered from recurrent corneal erosions. The attacks generally declined in frequency and intensity from the late 20s, but all examined individuals had developed subepithelial fibrosis by the age of 37. The fibrosis generally started in the mid periphery and was followed in some family members by central fibrosis and the development of gelatinous superficial elevations. Only a marginal reduction of visual acuity was seen in a few individuals. The affected individuals did not share haplotypes for genetic microsatellite markers surrounding genes that are known to cause autosomal-dominant corneal dystrophies. We describe a new type of autosomal-dominant corneal disorder with recurrent corneal erosions and subepithelial fibrosis not significantly affecting visual acuity.

Small Spot Phototherapeutic Keratectomy for Recurrent Corneal Erosion

To describe small spot phototherapeutic keratectomy (PTK) using the NIDEK EC-5000 excimer laser for the treatment of recurrent corneal erosion. This retrospective study analyzed patients with recurrent comeal erosion who were treated using small spot PTK. An electronic medical records database was used to retrieve patient data. Ten consecutive eyes in nine patients were evaluated after small spot PTK. Eight (80%) recovered without further erosion. Small spot PTK is a safe and effective alternative to traditional PTK and to corneal micropuncture in the treatment of recurrent corneal erosion.

Combination of transepithelial phototherapeutic keratectomy and autologous serum eyedrops for treatment of recurrent corneal erosions

The authors performed a nonrandomized, prospective, interventional clinical trial to evaluate the clinical outcome of the treatment of recurrent corneal erosions with a combination of transepithelial phototherapeutic keratectomy (t-PTK) and autologous serum eyedrops. Twenty-five eyes of 25 patients with a history of three to 12 post-traumatic, recurrent corneal erosions were treated with t-PTK using two bursts of 40 pulses (ablation depth 18.82 ± 2.56 μm using a 6.0 mm beam centered on the affected area. The median patient age was 40.6 years ± 12.0. Postoperatively, autologous serum eyedrops were administered six times daily for 6 weeks. The median follow-up was 15.5 months (range, 6 to 20 months). During the follow-up period, no patient had a change in refraction and no inflammatory or allergic reactions occurred. Twenty (80%) eyes had no further corneal erosions. Five eyes had corneal erosion, which was successfully treated in four eyes without further recurrence with continued use of autologous serum eyedrops without additional excimer laser treatment. One patient requested additional t-PTK treatment and recovered without further corneal erosions. The authors confirmed previous observations that t-PTK is an effective modality for the treatment of recurrent corneal erosions. They also postulate that their data suggests that autologous serum may be given as long-term artificial treatment postoperatively.—Michael D. Wagoner