title: Long-Term Outcomes of Epithelial Debridement and Diamond Burr Polishing for Corneal Epithelial Irregularity and Recurrent Corneal Erosion.
abstract: OBJECTIVE
  To determine the efficacy of epithelial debridement and diamond burr polishing (ED + DBP) in managing recurrent corneal erosion (RCE) and visually significant epithelial irregularity associated with epithelial basement membrane dystrophy (VS-EBMD).
  
  
  METHODS
  Retrospective, interventional, consecutive case series of all ED + DBP procedures performed between December 1, 2002, and December 1, 2014.
  
  
  RESULTS
  ED + DBP was performed in 91 eyes (66 patients) for the management of RCE and VS-EBMD. Sixty percent (55/91) of the procedures were performed for RCE, of which 65% (36/55) were associated with EBMD and 22% (12/55) with previous corneal trauma. Forty-six percent (42/91) of the procedures were performed for VS-EBMD, including 6 eyes with RCE. RCE resolved after treatment in 97% of eyes with >3 months of follow-up (mean, 33.2 months; range, 3.5-137.6 months). Corrected distance visual acuity (CDVA) and mean topographic astigmatism improved significantly in the 36 eyes treated for VS-EBMD with >1 month of follow-up. In none of the 22 eyes treated for VS-EBMD with >3 months of follow-up did EBMD recur (mean, 31.7 months; range, 3.2-137.6 months). Surgically induced subepithelial haze was present on last follow-up in 9.4% (8/85) of eyes with >1 month of follow-up, but was not associated with decreased final CDVA in any patient.
  
  
  CONCLUSIONS
  ED + DBP is effective in producing long-term resolution of RCE in 95% of treated eyes and significant improvement in CDVA, decreased topographic astigmatism, and long-term resolution of VS-EBMD in 100% of treated eyes.
authors.affiliation: Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Rosalind C
authors.initials: RC
authors.lastname: Vo
authors.forename: Judy L
authors.initials: JL
authors.lastname: Chen
authors.forename: P James
authors.initials: PJ
authors.lastname: Sanchez
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Aldave
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000503:physiopathology; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery; D003317:Corneal Dystrophies, Hereditary / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D003646:Debridement / Q000379:methods*; D019573:Epithelium, Corneal / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology