Alcohol delamination of the corneal epithelium for recurrent corneal erosion syndrome
Author:
Corresponding Author:

áine Ní Mhéalóid. Education and Research Centre, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin D02XK51, Ireland. ainenimhealoid@rcsi.ie

  • Article
  • | |
  • Metrics
  • |
  • Reference [20]
  • |
  • Related [20]
  • | | |
  • Comments
    Abstract:

    AIM: To evaluate the outcomes of alcohol delamination (ALD) of the corneal epithelium for the treatment of recurrent corneal erosion syndrome (RCES) and to implement a standardized treatment protocol for this condition utilizing evidence based practice and the findings of an internal audit. METHODS: A retrospective analysis of 42 eyes of 40 patients diagnosed with RCES who were treated with ALD between January 2006 and March 2016 was conducted. Patients had 20% alcohol applied to the cornea with the use of a well for 40s. Patients were reviewed one week later in the Outpatient Department. Outcome criteria were established based on standards from other studies in the medical literature. These included, a treatment success rate of at least 72% (defined as complete resolution of symptoms one month after treatment), a postoperative complication a rate of <5% (mainly infective keratitis, and subepithelial haze), and the absence of any detrimental effect on visual acuity in ≥95% of patients. RESULTS: The mean age at the time of ALD was 41.17±13.44y. Patients were followed for an average of 12.8±15.65mo. The majority were female (52.5%, n=21) and the majority of eyes treated with ALD were left eyes (62.9%, n=26). Trauma was the primary aetiology in our study population. Treatment was successful in 73.8% (n=31) of eyes and in 75% (n=30) of patients. Recurrence occurred in 26.2% of eyes at a mean of 10.41±12.63mo post treatment. CONCLUSION: ALD is an efficacious and cost-effective primary surgical intervention for RCES.

    Reference
    1 Hansen E. On den intermitterende keratitis visicularis neuralgica af traumatisk oprindelse. Hospitals Tindende 1872;201-203.
    2 Dua HS, Lagnado R, Raj D, Singh R, Mantry S, Gray T, Lowe J. Alcohol delamination of the corneal epithelium: an alternative in the management of recurrent corneal erosions. Ophthalmology 2006;113(3):404-411.
    3 Ramamurthi S, Rahman MQ, Dutton GN, Ramaesh K. Pathogenesis, clinical features and management of recurrent corneal erosions. Eye (Lond) 2006;20(6):635-644.
    4 Benitez-Del-Castillo JM, Rodríguez-Bayo S, Fontan-Rivas E, Martinez-de-la-Casa JM, Garcia-Sanchez J. Treatment of recurrent corneal erosion with substance P-derived peptide and insulin-like growth factor I. Arch Ophthalmol 2005;123(10):1445-1447.
    5 del Castillo JM, de la Casa JM, Sardiña RC, Fernández RM, Feijoo JG, Gómez AC, Rodero MM, Sánchez JG. Treatment of recurrent corneal erosions using autologous serum. Cornea 2002;21(8):781-783.
    6 Singh RP, Raj D, Pherwani A, Lagnado R, Abedin A, Eatamadi H, Mathew M, Dua HS. Alcohol delamination of the corneal epithelium for recalcitrant recurrent corneal erosion syndrome: a prospective study of efficacy and safety. Br J Ophthalmol 2007;91(7):908-911.
    7 Chan E, Jhanji V, Constantinou M, Amiel H, Snibson GR, Vajpayee RB. A randomised controlled trial of alcohol delamination and phototherapeutic keratectomy for the treatment of recurrent corneal erosion syndrome. Br J Ophthalmol 2014;98(2):166-171.
    8 Saini A, Rapuano CJ, Laibson PR, Cohen EJ, Hammersmith KM. Episodes of microbial keratitis with therapeutic silicone hydrogel bandage soft contact lenses. Eye Contact Lens 2013;39(5):324-328.
    9 Brown SI, Bloomfield S, Pearce DB, Tragakis M. Infections with the therapeutic soft lens. Arch Ophthalmol 1974;91(4):275-277.
    10 Brown N, Bron A. Recurrent erosion of the cornea. Br J Ophthalmol 1976;60(2):84-96.
    11 Hope-Ross MW, Chell PB, Kervick GN, McDonnell PJ. Recurrent corneal erosion: clinical features. Eye (Lond) 1994;8(Pt 4):373-377.
    12 Diez-Feijóo E, Grau AE, Abusleme EI, Durán JA. Clinical presentation and causes of recurrent corneal erosion syndrome: review of 100 patients. Cornea 2014;33(6):571-575.
    13 Reidy JJ, Paulus MP, Gona S. Recurrent erosions of the cornea: epidemiology and treatment. Cornea 2000;19(6):767-771.
    14 Shah S, Sebai Sarhan AR, Doyle SJ, Pillai CT, Dua HS. The epithelial flap for photorefractive keratectomy. Br J Ophthalmol 2001;85(4):393-396.
    15 Watson SL, Lee MH, Barker NH. Interventions for recurrent corneal erosions. Cochrane Database Syst Rev 2012;(9):CD001861.
    16 Hykin PG, Foss AE, Pavesio C, Dart JK. The natural history and management of recurrent corneal erosion: a prospective randomised trial. Eye (Lond) 1994;8(Pt 1):35-40.
    17 Sivak JM, Fini ME. MMPs in the eye: emerging roles for matrix metalloproteinases in ocular physiology. Prog Retin Eye Res 2002;21(1):1-14.
    18 Wong TT, Sethi C, Daniels JT, Limb GA, Murphy G, Khaw PT. Matrix metalloproteinases in disease and repair processes in the anterior segment. Surv Ophthalmol 2002;47(3):239-256.
    19 Garrana RM, Zieske JD, Assouline M, Gipson IK. Matrix metalloproteinases in epithelia from human recurrent corneal erosion. Invest Ophthalmol Vis Sci 1999;40(6):1266-1270.
    20 Wang L, Tsang H, Coroneo M. Treatment of recurrent corneal erosion syndrome using the combination of oral doxycycline and topical corticosteroid. Clin Exp Ophthalmol 2008;36(1):8-12.
    Cited by
    Comments
    Comments
    分享到微博
    Submit
Get Citation

áine Ní Mhéalóid, Taylor Lukasik, William Power,/et al.Alcohol delamination of the corneal epithelium for recurrent corneal erosion syndrome. Int J Ophthalmol, 2018,11(7):1129-1131

Copy
Share
Article Metrics
  • Abstract:1221
  • PDF: 546
  • HTML: 266
  • Cited by: 0
Publication History
  • Received:March 09,2018
  • Revised:April 16,2018
  • Online: July 10,2018