Recurrent corneal erosions treated with anterior stromal puncture by neodymium: yttrium-aluminum-garnet laser.
OBJECTIVE
To evaluate the clinical outcomes in patients with recurrent corneal erosions who received anterior stromal puncture by use of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser.


METHODS
Retrospective, nonrandomized, consecutive case series.


METHODS
From 2000 to 2005, 33 eyes of 33 patients with unilaterally recurrent macroform corneal erosions showing poor response to conservative management who were treated with Nd:YAG laser were studied.


METHODS
Anterior corneal stromal puncture with Nd:YAG laser was performed in the loosened epithelium or epithelial defect area. The causes and frequency of corneal erosions and the spot numbers and total energy of the Nd:YAG laser were recorded. Slit-lamp biomicroscopic examination, refraction, corneal topography, and times of laser were reviewed. A questionnaire regarding the preoperative and postoperative difference in the intensity of pain and frequency of corneal erosion was provided.


METHODS
Rate of recurrence and pain assessment by numerical rating scale.


RESULTS
Sixteen eyes were completely symptom free and 12 eyes had mild pain but no evidence of recurrent corneal erosion after operation. Five eyes had repeated episodes of recurrent corneal erosion. Eyes with a traumatic cause responded better to Nd:YAG laser therapy than those without. The frequency of corneal erosions and the severity of pain significantly improved in eyes with macroform and symptom-only recurrence. There was no significant change in refraction, but corneal surface regularity slightly improved after surgery. No adverse reaction was observed during follow-up.


CONCLUSIONS
Anterior stromal puncture by Nd:YAG laser is an effective and simple procedure to treat recurrent corneal erosion. It can ameliorate the frequency of attacks and the intensity of pain.
Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Tzu-Yun
TY
Tsai
Tzu-Hsun
TH
Tsai
Fung-Rong
FR
Hu
Yu-Chih
YC
Hou
D000328:Adult; D000368:Aged; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D003319:Corneal Stroma / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis; D011677:Punctures / Q000379:methods*; D012008:Recurrence; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult