Purpose:
To evaluate the demographic patterns and outcomes of patients with recurrent corneal erosion syndrome managed at a single center.
Methods:
A retrospective observational case series of patients presenting with recurrent erosion syndrome (RES) between April 2007 to September 2011. Demographic data, treatment modality and recurrence of erosions were noted. Major recurrence was defined as a documented episode of erosion on exam or by patient history and minor recurrence as the presence of mild pain, photophobia, and irritation at least 6 weeks after the procedure.
Results:
There were a total of 272 eyes of 230 patients with mean age 46.5 ± 14.6 years (2-85 years) and 53 % were females. The right eye was involved in 47% and 16% had bilateral involvement. The etiology of RES was epithelial basement membrane dystrophy (EBMD) in 145 eyes (53.3%), trauma in 70 eyes (25.7%), trauma with co-existent EBMD in 22 eyes (8.1%), other causes in 23 eyes (8.5%), and unknown in 10 eyes (3.7%). Eighty five patients (102 eyes) had a single visit and were excluded. Of the remaining 170 eyes (145 patients), 51.7% were managed conservatively, 40% with diamond burr (DB), 4.1% with phototherapeutic keratectomy (PTK), 2.4% with epithelial debridement (ED), and 1.8% with anterior stromal puncture (ASP). Of the 68 eyes treated with DB, 14 had < 1 month follow-up after DB, and were excluded. Major recurrence occurred in 14.8% (8/54) and minor in 11.1% (6/54) at median of 3.5 months (1.5-48 m) and 7.5 months (2-19) respectively. 7.4% eyes (4/54) were symptomatic at last follow-up at 13±12 months (1-53), and 7.4% eyes (4) required a repeat procedure. Mild haze was seen in 14.8% eyes (8) at 3 months. With PTK, major recurrence was seen in 28.6% eyes (2/7) and minor in 14.3% (1/7) at median 9 months (3-15) and 3 months post-operatively. One eye required repeat PTK. Mild haze was seen in 28.6% eyes at 3 months. With conservative management, major recurrence was seen in 34.6% eyes (27/78) at a median follow-up of 12 months (1.5-46 m) and minor recurrence in 11.5 % eyes (9/78). One patient on conservative treatment had an ulcer and required a penetrating keratoplasty.
Conclusions:
RES is most commonly associated with EBMD. Patients are mostly managed conservatively with 54% success and DB is the most common surgical intervention with 74% success.
Keywords: cornea: epithelium • clinical (human) or epidemiologic studies: outcomes/complications