Abstract
Purpose :
RCES is a common, chronic and relapsing condition, necessitating long-term follow-up. There remains uncertainty on whether the underlying aetiology of RCES should guide treatment choice. We performed a retrospective observational study to determine the rates of recurrence after phototherapeutic keratectomy (PTK) for different aetiologies of RCES.
Methods :
Single centre retrospective observational study. Patients with RCES who underwent PTK by the Cornea Unit at RVEEH from May 2015 to November 2017. Patients were classified based on history and examination as having RCES due to trauma, epithelial basement membrane dystrophy (EBMD), other or unknown. Patient demographics, history, examination and treatment for follow-ups were recorded and analysed. Recurrence was defined as an episode on history of painful episodes on waking or slit-lamp findings of corneal erosion.
Results :
70 patients were identified. 51% were males. Mean (±SD) age was 42 (±15.6) years.
8.57% had previously undergone PTK. Risk factors included prior trauma (54.3%), EBMD (25.7%), trauma and EBMD (5.7%), other (11.4%) and unknown (2.9%).
35.7% of all patients experienced a subsequent erosion, with mean time to recurrence of 127 days (range 4-487). 10% went on to have a repeat PTK. 32.4% and 41.2% of patients with a history of trauma and EBMD, respectively, experienced a subsequent erosion. There was no statistically significant difference in risk of recurrence after PTK between trauma and EBMD subgroups (p = 0.3608).
Conclusions :
RCES presents a significant disease burden to society given its relapsing course. Prior trauma was the most common risk factor. More than one-in-three patients had a further erosion during the study period. There was no correlation identified between RCES aetiology (trauma or EBMD) and rates of recurrence after treatment with PTK. Further prospective, randomised trials are required to guide directed treatment depending on the underlying aetiology of RCES.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.