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P. B. Kouyoumjian, R. R. Sayegh, G. Vedula, V. S. Nirankari; Cocaine-Assisted Epithelial Debridement for the Treatment of Anterior Basement Membrane Dystrophy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1159.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the outcome of the adjunctive use of topical cocaine in mechanical epithelial debridement for symptomatic anterior basement membrane dystrophy (ABMD).
Retrospective chart review. Patients with ABMD were treated with 4% topical cocaine followed by corneal epithelial debridement. Preoperative and postoperative visual acuities, keratometry readings, subjective symptoms, and evidence of disease recurrence were recorded.
Thirty-six eyes of 30 patients were treated. Eighteen were females. Mean best corrected visual acuity (BCVA) improved from 20/46 to 20/26 postoperatively. Postoperative corneal haze occurred in 1 eye. Erosion symptoms alone were noted in 14 eyes of 13 patients. Of these patients, only one experienced recurrence of corneal erosion. BCVA in this group improved from a mean of 20/40 preoperatively to 20/30. Reduced visual acuity from irregular astigmatism was the main presenting symptom in 17 eyes. BCVA in this group improved from a mean of 20/60 to 20/40 postoperatively. In the remaining 5 eyes that experienced both symptoms, BCVA improved from 20/40 to 20/20, and no recurrences were noted at the last follow-up visit.
Topical cocaine-assisted epithelial debridement is a simple, safe and effective method for treating patients with ABMD who suffer from recurrent corneal erosions and/or decreased visual acuity. Cocaine may act in a similar way to alcohol, leaving behind a smooth corneal surface for regenerating epithelial cells to attach firmly.
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