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M.A. Roberts, A.J. Aldave; Epithelial debridement and diamond burr polishing of Bowman's layer in the management of recalcitrant recurrent corneal erosions . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2956.
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Purpose: Report the safety and efficacy of epithelial debridement with diamond burr polishing of Bowman’s layer for management of recalcitrant corneal erosions. Methods: Interventional case series of 9 patients (14 eyes) with recurrent corneal epithelial erosions that had failed to respond to conservative therapy. For each patient, the following information was recorded: history of ocular trauma, frequency of corneal erosions prior to treatment, previous medical and surgical treatment, pre–operative and post–operative visual acuities, and the occurrence of corneal erosions and other complications following epithelial debridement. Results: The 9 patients had been treated for an average of 4 episodes (range, 1–7 episodes) of spontaneous corneal erosions prior to presentation. One patient (2 eyes) had a history of prior corneal trauma and 5 patients (9 eyes) demonstrated clinical findings of anterior basement membrane dystrophy. In 1 patient (1 eye), epithelial debridement had been performed twice, and all patients had been treated conservatively with ocular lubrication, topical hypertonic agents, and/or bandage soft contact lenses. All patients demonstrated global epithelial dysadherence at the time of epithelial debridement. Post–operatively, four patients (6 eyes) developed faint subepithelial haze, first noted 6–12 days after the procedure, which was not symptomatic in any patient. All patients were within 1 line of pre–operative best spectacle corrected visual acuity at an average follow–up period of 140 days (range, 37–353 days). No patient experienced a recurrent corneal erosion during the follow–up interval. Conclusions: Epithelial debridement with diamond burr polishing of Bowman’s layer is a safe and effective treatment for recurrent corneal erosions in patients with corneal epithelial dysadherence refractory to more conservative therapy.
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