EXTENDED REPORT

Alcohol delamination of the corneal epithelium for recalcitrant recurrent corneal erosion syndrome: a prospective study of efficacy and safety

Ravinder P Singh¹, Dev Raj¹, Anupama Pherwani¹, Ruby Lagnado², Asiya Abedin¹, Habibullah Eatamadi¹, Manu Mathew¹ and Harminder S Dua¹

¹ Division of Ophthalmology and Visual Sciences, University of Nottingham, University Hospital, Queen’s Medical Centre, Nottingham, UK
² Huddersfield Royal Infirmary, West Yorkshire, UK

Correspondence to:
Correspondence to:
Professor H S Dua
Division of Ophthalmology and Visual Sciences, B Floor, Eye Ear Nose Throat Centre, University Hospital, Queen’s Medical Centre, Nottingham NG7 2UH, UK; harminder.dua{at}nottingham.ac.uk

Aim: To investigate the safety and efficacy of alcohol delamination of the corneal epithelium for recalcitrant recurrent corneal erosion syndrome (RCE) in a prospective non-comparative interventional case series.

Methods: Patients with RCE who remained symptomatic despite topical lubrication and 3-month use of an extended wear (bandage) contact lens were included. The intensity of pain on a scale of 1 to 10, and duration and frequency of attacks were recorded. Patients were treated with alcohol delamination and followed up at 1 week, 1 month and then at 12 months, which was the minimum follow up time. Success was defined as a resolution of symptoms after 1 month of treatment, and partial success as a significant reduction in symptoms manageable with topical lubricants, and failure where symptoms were unchanged or worsened.

Results: 20 eyes of 20 patients with RCE caused by trauma (n = 14), anterior basement membrane dystrophy (n = 5) or idiopathic (1) were studied. The mean age of patients was 44 years and mean follow-up 24 months. Two eyes were lost to follow-up. 15 (83%) eyes were qualified as successes, 3 as partial successes and no failures were seen. No intraoperative complications were observed. 1 patient developed transient subepithelial haze that resolved with topical steroid, 1 had a change in refraction and 1 developed herpetic stromal keratitis 2 months postoperatively, which was successfully treated. No loss of vision was observed in any of the patients.

Conclusion: Alcohol delamination of the corneal epithelium is a safe and effective method for treating patients with recalcitrant RCE.

Abbreviations: ADCE, alcohol delamination of the corneal epithelium; BCL, bandage-soft contact lens; BSS, balanced salt solution; ND:YAG, neodymium-doped:yttrium aluminium garnet; PTK, phototherapeutic keratectomy; RCE, recurrent corneal erosion

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

BJO at a glance

Creig Hoyt
Br. J. Ophthalmol. 2007 91: 847. [Extract] [Full Text] [PDF]