Alcohol delamination of the corneal epithelium for recalcitrant recurrent corneal erosion syndrome: a prospective study of efficacy and safety.
OBJECTIVE
To investigate the safety and efficacy of alcohol delamination of the corneal epithelium for recalcitrant recurrent corneal erosion syndrome (RCE) in a prospective non-comparative interventional case series.


METHODS
Patients with RCE who remained symptomatic despite topical lubrication and 3-month use of an extended wear (bandage) contact lens were included. The intensity of pain on a scale of 1 to 10, and duration and frequency of attacks were recorded. Patients were treated with alcohol delamination and followed up at 1 week, 1 month and then at 12 months, which was the minimum follow up time. Success was defined as a resolution of symptoms after 1 month of treatment, and partial success as a significant reduction in symptoms manageable with topical lubricants, and failure where symptoms were unchanged or worsened.


RESULTS
20 eyes of 20 patients with RCE caused by trauma (n = 14), anterior basement membrane dystrophy (n = 5) or idiopathic (1) were studied. The mean age of patients was 44 years and mean follow-up 24 months. Two eyes were lost to follow-up. 15 (83%) eyes were qualified as successes, 3 as partial successes and no failures were seen. No intraoperative complications were observed. 1 patient developed transient subepithelial haze that resolved with topical steroid, 1 had a change in refraction and 1 developed herpetic stromal keratitis 2 months postoperatively, which was successfully treated. No loss of vision was observed in any of the patients.


CONCLUSIONS
Alcohol delamination of the corneal epithelium is a safe and effective method for treating patients with recalcitrant RCE.
Singh
Ravinder P
RP
Division of Ophthalmology and Visual Sciences, University of Nottingham, University Hospital, Queen's Medical Centre, Nottingham NG7 2UH, UK.
Raj
Dev
D
Pherwani
Anupama
A
Lagnado
Ruby
R
Abedin
Asiya
A
Eatamadi
Habibullah
H
Mathew
Manu
M
Dua
Harminder S
HS
D000328:Adult; D000368:Aged; D003262:Contact Lenses, Extended-Wear; D003316:Corneal Diseases / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D065306:Corneal Injuries; D019573:Epithelium, Corneal / Q000187:drug effects*; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D010147:Pain Measurement; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index
D009883:Ophthalmic Solutions; D000431:Ethanol