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

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: Retrospecti...

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Main Authors: Aldave, Anthony J., Mohd. Kamal, Khairidzan, Vo, Rosalind C.
Format: Article
Language:English
Published: Lippincot William @ Wilkins 2009
Subjects:
Online Access:http://irep.iium.edu.my/415/1/Epithelial_debridement_and_Bowman%27s_layer.pdf
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author Aldave, Anthony J.
Mohd. Kamal, Khairidzan
Vo, Rosalind C.
author_facet Aldave, Anthony J.
Mohd. Kamal, Khairidzan
Vo, Rosalind C.
author_sort Aldave, Anthony J.
collection IIUM
description 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.
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spelling oai:generic.eprints.org:4152012-02-14T01:15:26Z http://irep.iium.edu.my/415/ Epithelial debridement and Bowman's layer polishing for visually significant epithelial irregularity and recurrent corneal erosions Aldave, Anthony J. Mohd. Kamal, Khairidzan Vo, Rosalind C. RE Ophthalmology 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. Lippincot William @ Wilkins 2009-12 Article PeerReviewed application/pdf en http://irep.iium.edu.my/415/1/Epithelial_debridement_and_Bowman%27s_layer.pdf 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 http://www.ncbi.nlm.nih.gov/pubmed/19730089
spellingShingle RE Ophthalmology
Aldave, Anthony J.
Mohd. Kamal, Khairidzan
Vo, Rosalind C.
Epithelial debridement and Bowman's layer polishing for visually significant epithelial irregularity and recurrent corneal erosions
title Epithelial debridement and Bowman's layer polishing for visually significant epithelial irregularity and recurrent corneal erosions
title_full Epithelial debridement and Bowman's layer polishing for visually significant epithelial irregularity and recurrent corneal erosions
title_fullStr Epithelial debridement and Bowman's layer polishing for visually significant epithelial irregularity and recurrent corneal erosions
title_full_unstemmed Epithelial debridement and Bowman's layer polishing for visually significant epithelial irregularity and recurrent corneal erosions
title_short Epithelial debridement and Bowman's layer polishing for visually significant epithelial irregularity and recurrent corneal erosions
title_sort epithelial debridement and bowman s layer polishing for visually significant epithelial irregularity and recurrent corneal erosions
topic RE Ophthalmology
url http://irep.iium.edu.my/415/1/Epithelial_debridement_and_Bowman%27s_layer.pdf
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