Pathogenesis and treatment of recurrent erosion.

Williams, R. E. O.; Buckley, Roger

doi:10.1136/bjo.69.6.435

Cited by 59 publications

(30 citation statements)

References 13 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 A prospective trial of contact lenses vs lubrication in patients with RCE found that contact lenses were inferior and showed a higher complication rate. 16 The authors have a similar experience, and we generally do not use bandage contact lenses for more than a week in the presence of an epithelial defect.…”

Section: Therapeutic Bandage Contact Lensesmentioning

confidence: 98%

“…2 It has been suggested that recurrences occur in close proximity to the Hudson-Stahli line. 16 In moderate and large-sized erosions involving the central cornea, the last area to re-epithelialise is in the midline below the horizontal meridian. This is because the centripetally moving convex fronts of healing epithelium meet at the apex, and the integration of different fronts of basement membrane takes longest at this point, thus predisposing it to subsequent breakdown.…”

Section: Clinical Featuresmentioning

confidence: 99%

See 1 more Smart Citation

Pathogenesis, clinical features and management of recurrent corneal erosions

Ramamurthi

Rahman

Dutton

et al. 2005

Eye

109

View full text Add to dashboard Cite

Recurrent corneal erosions (RCE) are common. They are characterised by repeated episodes of pain, difficulty in opening the eyes, watering, and photophobia resulting from poor epithelial adhesion. In the majority of patients with RCE, trauma is the initiating factor. Epithelial, stromal, and endothelial corneal dystrophies have all been described in association with RCE. Other causes that may lead to RCE include chemical and thermal injuries, previous herpetic keratitis, meibomian gland dysfunction, ocular rosacea, diabetes mellitus, Salzmann's nodular degeneration, band keratopathy, previous bacterial ulceration, kerato-conjunctivitis sicca, and epidermolysis bullosa. The conditions that are associated with RCE can be either primary or secondary depending on whether the basement membrane complex abnormality is intrinsic or acquired. Primary types tend to be bilateral, symmetrical and develop in multiple corneal locations. The pathogenetic mechanism of this disorder is related to poor adhesion of the corneal epithelium to the underlying stroma. Excessive matrix metalloproteinase (MMP) activity may play a role in the pathogenesis. Although the majority of patients will respond to simple measures such as padding and antibiotic ointment, RCE resistant to simple measures require approaches that are more elaborate. The common goal of these approaches is to encourage proper formation of adhesion complexes between the epithelium and the stroma. The use of longterm contact lenses, autologous serum eye drops, botulinum toxin, induced ptosis, oral MMP inhibitors, diamond burr polishing of Bowman's membrane have been reported with varying degree of success in treating RCE. Anterior stromal puncture with insulin needles or Neodymium : aluminium-yttriumgarnet may enhance the epithelial adhesion to the basement membrane by scar formation and success rates of up to 80% have been reported in the treatment of recalcitrant RCE. Excimer laser photo-therapeutic keratectomy (PTK) is now a well-established treatment modality for RCE and is being used both safely and effectively. Partial ablation of Bowman's layer with PTK gives a smooth surface for the newly generating epithelium to migrate and form adhesion complexes. The pathogenesis, clinical features, and management options of this common disorder are discussed in this review article.

show abstract

Section: Therapeutic Bandage Contact Lensesmentioning

confidence: 98%

Section: Clinical Featuresmentioning

confidence: 99%

Pathogenesis, clinical features and management of recurrent corneal erosions

Ramamurthi

Rahman

Dutton

et al. 2005

Eye

109

View full text Add to dashboard Cite

show abstract

“…20 The aim of this study was to assess the morphologic and functional long-term results of minimal invasive subepithelial PTK for corneal MDF.…”

mentioning

confidence: 99%

Long-Term Results of Phototherapeutic Keratectomy for Corneal Map-Dot-Fingerprint Dystrophy (Cogan-Guerry)

Pogorelov

Langenbucher

Kruse

et al. 2006

Cornea

View full text Add to dashboard Cite

show abstract

“…Viele der Patienten konnen zufriedenstellend mit Salbenverbanden, therapeutischen Kontaktlinsen bzw. einer mechanischen Epithelabrasio [1,19,20] behandelt werden. Die vordere Hornhautstromapunktion mit einer Nadel [12] oder mit dem Nd:YAG-Laser [5] werden wegen moglicher storender Narbenbildung oder sogar Perforationsgefahr eher widerspruchlich bewertet.…”

Section: Introductionunclassified

Excimer laser (193 nm) phototherapeutic keratectomy for recurrent corneal erosions — own results

Kölli¹,

Faschinger²,

Ganser³

et al. 1999

Spektrum Augeheilkd

View full text Add to dashboard Cite

Zusammenfassung. Das Auftreten einer rezidivierendenHornhauterosion lasst sich in manchen Fallen nur unbefriedigend mit konservativen Methoden (Salbenverbande, Applikation von therapeutischen Kontaktlinsen, mechanische Epithelabrasio u. a.) behandeln. Ziel dieser Studie war es, unsere Ergebnisse im Hinblick auf Effizienz, Sicherheit and mogliche Komplikationen der phototherapeutischen Keratektomie mittels Excimer-Laser bei diesem Krankheitsbild zu evaluieren and in Vergleich mit bisherigen Studien zu bringen.Bei 12 Augen von 11 Patienten mit einem mittleren Alter von 32,5 Jahren (25-56 Jahre), Traumaanamnese sowie Auftreten von im Mittel 2,8 (2 bis 7) praoperativen Rezidiven and unbefriedigender konservativer Behandlung wurde bei bestehender Hornhauterosion eine phototherapeutische Keratektonie mittels Excimer-Laser nach vorhergehender mechanischer teilweiser Epithelabrasio durchgefuhrt.Eine Reepithelialisierung erfolgte bei allen Patienten ohne Komplikationen innerhalb von 2 his 6 Tagen. Die Nachbeobachtungszeit betrug mindestens 3 and langstens 26 Monate (im Mittel 12,4 Monate). Eine Anderung der Refraktion war in keinem Fall zu beobachten, postoperative Rezidivfreiheit war in 10 der 11 Patienten (90,9%) erreicht worden. In einem Fall kam es zu einem mittlerweile dreimaligen Auftreten eines Rezidives, welches konservativ behandelt werden konnte.Unsere Ergebnisse stehen im Einklang mit bisher erschienenen Studien auf diesem Gebiet, weshalb die Durchfuhrung einer phototherapeutischen Keratektomie bei rezidivierender Hornhauterosion mit Traumaanamnese mittels Excimer-Laser empfohlen werden kann, da es sich um eine sichere and wirkungsvolle Behandlungsmethode handelt.Schliisselworter: Rezidivierende Hornhauterosion, Phototherapeutische Keratektomie, Excimer-Laser. Excimer laser (193 nm) phototherapeutic keratectomy for recurrent corneal erosionsown resultsSummary. Recurrent corneal erosion may be a difficult disorder to treat and is sometimes refractory to conservative treatment (e. g. lubricant ointments, bandage contact lenses, corneal abrasion). Our purpose was to evaluate the safety and efficacy of excimer laser phototherapeutic keratectomy (PTK) and to compare our results to recently published studies.12 eyes of 11 patients underwent laser treatment, age ranged from 25 to 26 years (mean 32.5 years). All cases followed corneal trauma, recurrent erosions ranged from 2 to 7 times (mean 2.8), and there was no response to conservative treatment. After epithelial debridement excimer laser phototherapeutic keratectomy was performed to Bowman's layer.Time to reepithelialization ranged from 2 to 6 days, follow-up time ranged from 3 to 26 months (mean 12.4), no change in visual acuity or spectacle correction was noted. In one case corneal erosion occurred recently three times after treatment but all other cases (90.9%) were symptom-free for the following time.In summary our results are similiar to recently published studies and excimer laser phototherapeutic keratectomy can be recommended as a safe and effective tool in...

show abstract

Pathogenesis and treatment of recurrent erosion.

Cited by 59 publications

References 13 publications

Pathogenesis, clinical features and management of recurrent corneal erosions

Pathogenesis, clinical features and management of recurrent corneal erosions

Long-Term Results of Phototherapeutic Keratectomy for Corneal Map-Dot-Fingerprint Dystrophy (Cogan-Guerry)

Excimer laser (193 nm) phototherapeutic keratectomy for recurrent corneal erosions — own results

Contact Info

Product

Resources

About