Epithelial debridement and Bowman's layer polishing for visually significant epithelial irregularity and recurrent corneal erosions

Aldave, Anthony J. and Mohd. Kamal, Khairidzan and Vo, Rosalind C. (2009) Epithelial debridement and Bowman's layer polishing for visually significant epithelial irregularity and recurrent corneal erosions. Cornea, 28 (10). pp. 1085-1090. ISSN 1536-4798

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Abstract

PURPOSE: To report the utility of epithelial debridement and diamond burr polishing of Bowman's layer (ED + DBP) in the management of recurrent corneal erosions and visually significant epithelial irregularity associated with epithelial basement membrane dystrophy (EBMD). DESIGN: Retrospective interventional consecutive case series. PARTICIPANTS: All patients who underwent ED + DBP by a single surgeon between November 1, 2002 and November 1, 2008. METHODS: Data were collected regarding the frequency and severity of symptoms associated with EBMD as well as previous treatments. Details regarding the procedure and the postoperative course were recorded as well. The significance of the improvement in visual acuity after treatment was determined using Wilcoxon signed rank test. MAIN OUTCOME MEASURES: Change in visual acuity and recurrent corneal erosions after treatment. RESULTS: ED + DBP was performed on 56 eyes (42 patients) during the 72-month period under review. Of the 56 eyes, 37 (66%) were treated for recurrent corneal erosions and 22 (39%) were treated for visually significant epithelial irregularity (3 eyes were treated for both conditions). EBMD was diagnosed in 46 eyes (82%), and a history of corneal trauma was elicited in 9 eyes (16%). Visual acuity improved significantly (P = 0.016), and recurrent corneal erosions resolved after treatment in 24 (96%) of the 25 eyes with a history of corneal erosions before treatment with more than 3 months of follow-up (average, 18.9 months; range, 3.5-66.5 months). Visual acuity improved significantly (P = 0.004), and visual aberrations related to epithelial irregularity resolved in all 14 eyes treated for visually significant EBMD with more than 3 months of follow-up (average, 14.2 months; range, 3.4-50.8 months). Mild, central subepithelial corneal haze developed in 12 (26%) of the 47 eyes that did not demonstrate subepithelial haze before ED + DBP, although it was not associated with decreased vision at the last follow-up visit in any patient. CONCLUSIONS: ED + DBP is a safe and effective technique in the management of recurrent corneal erosions and visually significant epithelial irregularity associated with EBMD.

Item Type:	Article (Journal)
Additional Information:	3389/415
Uncontrolled Keywords:	Bowman Membrane/surgery, Corneal Diseases/surgery
Subjects:	R Medicine > RE Ophthalmology
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine
Depositing User:	Mrs. Wan Salwati Wan Salleh
Date Deposited:	16 Jun 2011 13:35
Last Modified:	14 Feb 2012 09:15
URI:	http://irep.iium.edu.my/id/eprint/415

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