Document Detail

Epithelial debridement and Bowman's layer polishing for visually significant epithelial irregularity and recurrent corneal erosions.
MedLine Citation:
PMID:  19730089     Owner:  NLM     Status:  MEDLINE    
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.
Anthony J Aldave; Khairidzan M Kamal; Rosalind C Vo; Fei Yu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cornea     Volume:  28     ISSN:  1536-4798     ISO Abbreviation:  Cornea     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-03     Completed Date:  2010-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1085-90     Citation Subset:  IM    
Jules Stein Eye Institute, the David Geffen School of Medicine at the University of California, Los Angeles, 90095, USA.
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MeSH Terms
Aged, 80 and over
Bowman Membrane / surgery*
Corneal Diseases / complications,  diagnosis,  surgery*
Corneal Topography
Epithelium, Corneal / surgery*
Medical Records
Middle Aged
Postoperative Complications
Retrospective Studies
Treatment Outcome
Vision Disorders / etiology,  physiopathology
Visual Acuity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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