Recurrent corneal erosion: a comprehensive review

Darby D Miller,1 Syed A Hasan,1 Nathaniel L Simmons,2 Michael W Stewart1 1Department of Ophthalmology, Mayo Clinic, Jacksonville, FL 32224, USA; 2Department of Ophthalmology, University of Rochester, Rochester, NY 14642, USA Purpose: To comprehensively review the literature regarding recurrent cor...

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Autores principales:	Miller DD, Hasan SA, Simmons NL, Stewart MW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Recurrent corneal erosion anterior basement membrane dystrophy map-dot-fingerprint dystrophy epithelial basement membrane dystrophy corneal abrasion. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/86a16cf0e325412b8b7da56616557a71
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spelling	oai:doaj.org-article:86a16cf0e325412b8b7da56616557a712021-12-02T05:07:07ZRecurrent corneal erosion: a comprehensive review1177-5483https://doaj.org/article/86a16cf0e325412b8b7da56616557a712019-02-01T00:00:00Zhttps://www.dovepress.com/recurrent-corneal-erosion-a-comprehensive-review-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Darby D Miller,1 Syed A Hasan,1 Nathaniel L Simmons,2 Michael W Stewart1 1Department of Ophthalmology, Mayo Clinic, Jacksonville, FL 32224, USA; 2Department of Ophthalmology, University of Rochester, Rochester, NY 14642, USA Purpose: To comprehensively review the literature regarding recurrent corneal erosion (RCE) and to present treatment options and recommendations for management.Overview: RCE usually presents with sharp, unilateral pain upon awakening, in an eye with an underlying basement membrane dystrophy, prior ocular trauma, stromal dystrophy or degeneration, or prior surgery for refractive errors, cataracts, or corneal transplantation. Making the correct diagnosis requires a careful slit-lamp examination of both eyes coupled with a high degree of suspicion. Several treatments are commonly used for RCE but new therapies have been introduced recently. Conservative treatment consists of antibiotic and preservative-free lubricating drops, with topical cycloplegics and oral analgesics to control pain. Patients who are unresponsive to these therapies may benefit from therapeutic bandage contact lenses (BCL). Newer therapies include oral matrix metalloproteinase (MMP) inhibitors, blood-derived eye drops, amniotic membrane graft application, and judicious application of topical corticosteroids. Once the epithelium is healed, a course of hypertonic saline solution and/or ointment can be used. Surgical procedures may be performed in patients who fail conservative therapy. Punctal occlusion with plugs increases the tear film volume. Epithelial debridement with diamond burr polishing (DBP), anterior stromal puncture (ASP), or alcohol delamination should be considered in selected patients. DBP can be used for patients with basement membrane dystrophies and is the preferred treatment overall due to a low recurrence rate. ASP can be used for erosions outside the central visual axis. Excimer laser phototherapeutic keratectomy is an attractive option in eyes with central RCE since it precisely removes tissue while preserving corneal transparency. In patients with RCE who are also candidates for refractive surgery, photorefractive keratectomy can be considered.Summary: Newly introduced therapies for RCE enable therapy to be individualized and lower the recurrence rate. Keywords: recurrent corneal erosion, anterior basement membrane dystrophy, map-dot-fingerprint dystrophy, epithelial basement membrane dystrophy, corneal abrasionMiller DDHasan SASimmons NLStewart MWDove Medical PressarticleRecurrent corneal erosionanterior basement membrane dystrophymap-dot-fingerprint dystrophyepithelial basement membrane dystrophycorneal abrasion.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 325-335 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Recurrent corneal erosion anterior basement membrane dystrophy map-dot-fingerprint dystrophy epithelial basement membrane dystrophy corneal abrasion. Ophthalmology RE1-994
spellingShingle	Recurrent corneal erosion anterior basement membrane dystrophy map-dot-fingerprint dystrophy epithelial basement membrane dystrophy corneal abrasion. Ophthalmology RE1-994 Miller DD Hasan SA Simmons NL Stewart MW Recurrent corneal erosion: a comprehensive review
description	Darby D Miller,1 Syed A Hasan,1 Nathaniel L Simmons,2 Michael W Stewart1 1Department of Ophthalmology, Mayo Clinic, Jacksonville, FL 32224, USA; 2Department of Ophthalmology, University of Rochester, Rochester, NY 14642, USA Purpose: To comprehensively review the literature regarding recurrent corneal erosion (RCE) and to present treatment options and recommendations for management.Overview: RCE usually presents with sharp, unilateral pain upon awakening, in an eye with an underlying basement membrane dystrophy, prior ocular trauma, stromal dystrophy or degeneration, or prior surgery for refractive errors, cataracts, or corneal transplantation. Making the correct diagnosis requires a careful slit-lamp examination of both eyes coupled with a high degree of suspicion. Several treatments are commonly used for RCE but new therapies have been introduced recently. Conservative treatment consists of antibiotic and preservative-free lubricating drops, with topical cycloplegics and oral analgesics to control pain. Patients who are unresponsive to these therapies may benefit from therapeutic bandage contact lenses (BCL). Newer therapies include oral matrix metalloproteinase (MMP) inhibitors, blood-derived eye drops, amniotic membrane graft application, and judicious application of topical corticosteroids. Once the epithelium is healed, a course of hypertonic saline solution and/or ointment can be used. Surgical procedures may be performed in patients who fail conservative therapy. Punctal occlusion with plugs increases the tear film volume. Epithelial debridement with diamond burr polishing (DBP), anterior stromal puncture (ASP), or alcohol delamination should be considered in selected patients. DBP can be used for patients with basement membrane dystrophies and is the preferred treatment overall due to a low recurrence rate. ASP can be used for erosions outside the central visual axis. Excimer laser phototherapeutic keratectomy is an attractive option in eyes with central RCE since it precisely removes tissue while preserving corneal transparency. In patients with RCE who are also candidates for refractive surgery, photorefractive keratectomy can be considered.Summary: Newly introduced therapies for RCE enable therapy to be individualized and lower the recurrence rate. Keywords: recurrent corneal erosion, anterior basement membrane dystrophy, map-dot-fingerprint dystrophy, epithelial basement membrane dystrophy, corneal abrasion
format	article
author	Miller DD Hasan SA Simmons NL Stewart MW
author_facet	Miller DD Hasan SA Simmons NL Stewart MW
author_sort	Miller DD
title	Recurrent corneal erosion: a comprehensive review
title_short	Recurrent corneal erosion: a comprehensive review
title_full	Recurrent corneal erosion: a comprehensive review
title_fullStr	Recurrent corneal erosion: a comprehensive review
title_full_unstemmed	Recurrent corneal erosion: a comprehensive review
title_sort	recurrent corneal erosion: a comprehensive review
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/86a16cf0e325412b8b7da56616557a71
work_keys_str_mv	AT millerdd recurrentcornealerosionacomprehensivereview AT hasansa recurrentcornealerosionacomprehensivereview AT simmonsnl recurrentcornealerosionacomprehensivereview AT stewartmw recurrentcornealerosionacomprehensivereview
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Recurrent corneal erosion: a comprehensive review

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