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Scott G Hauswirth; The Effect of Debridement and Amnion Tissue on Vision in Patients with Anterior Basement Membrane Dystrophy: A Short Case Series. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5641.
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Anterior basement membrane dystrophy is a common condition which may reduce best corrected spectacle acuity. Pharmacologic treatments have little effect, and the condition is typically not treated by any further intervention unless it progresses to corneal erosions. This case series demonstrates improvement in patient satisfaction, best corrected visual acuity, and topography, utilizing simple epithelial debridement, light buffing of the basement membrane, and placement of amnion tissue.
Retrospective Case Series. Two patients with non-erosive anterior basement membrane dystrophy of the cornea elected to undergo treatment to improve vision. Patients consented to the following procedure: 1 drop topical 0.5% proparicaine, 1 drop topical azithromycin 1.0% placed. Cornea was debrided using algar brush tipped with diamond burr. Approximately 3.0mm to 5.0mm of central corneal epithelium was removed. Diamond burr buffing over the denuded Bowman's layer was performed. Self-retaining amnion tissue was inserted into eye. Tape tarsorraphy placed on upper eyelid to improve comfort and reduce air exposure of amnion tissue. 7-10 days following procedure, patients returned for removal of amniotic membrane. Follow up to 5 months was observed.
Baseline best corrected visual acuity was 20/40 in patient one and 20/30 in patient two. Improvement of BCVA at one month to 20/25 in both patients. Topographic analysis of pre- and post- treatment showed subtle improvements consisted with reduction of surface irregularity. No increase in corneal haze, resultant episodes of corneal erosions, or large refractive shifts were noted.
Patients with visually significant anterior basement membrane dystrophy may experience improvement in best corrected visual acuity as well as improved surface regularity by performing this short in-office procedure. No complications were encountered in these two patients, however larger studies with greater numbers of patients should be performed to fully assess risk and efficacy.
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