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Scott G Hauswirth, Milton M Hom; Taking the Recurrence out of Recurrent Corneal Erosions: A Case Series. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2612.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Recurrent corneal erosion (RCE) is a corneal entity common to clinical practice. Review of the literature states that few comparative studies exist between different treatment methods, with success rates varying from 20-98%. When the erosion occurs months or years following the initial injury, the recurrent nature of the condition may not be clear. Thus, development of an algorithm for treating potential RCE cases is warranted.
Methods: Retrospective review of 53 cases of RCE seen by single provider at a single site. Patients were included only if they followed a standardized post-procedure protocol utilizing the same post-procedure antibiotic and hyperosmotic solutions, and had a minimum of 6 months follow-up. Recurrence rate over the six month follow up period was the primary outcome measure. Recurrence was defined as an episode of pain in the affected eye or visible epithelial slough in the treated eye. Patients were grouped according to treatment type: bandage contact lens (BCL) alone, epithelial debridement with bandage contact lens (ED+BCL), and epithelial debridement with cryopreserved amniotic membrane (ED+CAM).
Results: Mean ages of the groups were as follows: BCL 57.8 years (range 41-68years), ED+BCL 45.3 years (range 31-72 years), ED+CAM 58.6 years (range 39-83 years). Recurrence rates of the following treatments were noted: BCL group had 4/6 (67.6%) recur, with recurrence rate of 0.1111. ED+BCL had 3/6 (50%) recur, with recurrence rate of 0.0833. ED+CAM had 1/7 (14.2%) recurrence, with recurrence rate of 0.0238. Weighing these statistics, the following algorithm was developed: first occurrence/presentation (questionable RCE component): lubrication, hyperosmotics, and BCL. Second occurrence (high suspicion of RCE): discussion and possible utilization of ED+CAM. Third occurrence/confirmation of RCE: perform ED+CAM.
Conclusions: Given the varying clinical presentation in severity of ABMD and potential for RCE recurrence, we feel the risk-to-benefit to patients utilizing this algorithm is beneficial to patients, and utilizes a best practices approach for treatment of a difficult clinical condition. It may be utilized as a guideline for clinicians wishing to employ a more standardized methodology in treating this condition.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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