Abstract

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 months use of an extended wear (bandage) contact lens were included. The intensity of pain on a scale of 1 to10, as well as 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 for minimum follow up time. Success was defined as resolution of symptoms after one month of treatment, partial success as 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 (14), anterior basement membrane dystrophy (5) and idiopathic (1) were studied. The mean age was 44 years and mean follow up 24 months. Two eyes were lost to follow-up. Fifteen eyes (83%) qualified as success, 3 as partial success and no failures were seen. No intraoperative complications were observed. One patient developed transient subepithelial haze that resolved with topical steroid, one patient had a change in refraction and one patient 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.