Efficacy of Anterior Stromal Puncture Using 5% NaCl Eye Drops for Prolonged Time in Recurrent Corneal Erosion Syndrome

PURPOSE: The purpose of this study is to evaluate the efficacy of the combined treatment of anterior stromal puncture with the concurrent use of 5% NaCl eye drops for 6 months for recurrent corneal erosion syndrome. METHODS: A retrospective chart review was conducted for 21 patients (21 eyes) who underwent the combined treatment of anterior stromal puncture with 5% NaCl eye drops qid for 6 months to treat recurrent corneal erosion syndromes. The patients' age, gender, history of corneal trauma, history of ocular surgery, recurrence rate, need for additional treatments after recurrence and complication were analyzed. RESULTS: The mean age was 42.05 ± 13.83 years (19-68 years) with no significant difference in gender, and the mean follow up period was 8.48 ± 2.76 months (6-15 months). Among the 21 eyes 14 eyes (66.7%) had a previous history of corneal trauma, 2 eyes (9.52%) had previous refractive surgery, 1 eye (4.8%) had corneal dystrophy, 2 eyes (9.5%) had diabetic mellitus and 5 eyes (28.81%) had an unknown origin. Furthermore, 3 eyes (14.3%) developed recurrences and 2 eyes were resolved with conservative treatment while 1 eye needed additional anterior stroma puncture. There was no recurrence after retreatment with anterior stroma puncture. No significant complications such as infection or inflammation developed with the exception of corneal opacity in which one patient developed glare due to corneal opacity. CONCLUSIONS: The combined treatment of anterior stromal puncture with 5% NaCl eye drops for a prolonged time might be effective at preventing the recurrence of refractory recurrent corneal erosion syndrome with conservative treatments.

Comparison of Nd:YAG Laser versus Conservative Management in the Treatment of Recurrent Corneal Erosion

PURPOSE: To compare the treatment effects of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser and conservative management in treatment of recurrent corneal erosion. METHODS: Twenty-three eyes that received Nd:YAG laser treatment and 24 eyes that underwent conservative management including hyperosmotic agent were retrospectively reviewed for the rate and frequency of recurrence, presentation, time to recurrence, final visual acuity and complications. RESULTS: The rate of recurrence in eyes treated with Nd:YAG laser was 56.5% and that in eyes with conservative management was 50.0%. The difference was not statistically significant (p = 0.654). However, 10 of 12 eyes that recurred after conservative treatment presented with macroform erosion at the time of recurrence, whereas 5 of 13 eyes that recurred after Nd:YAG laser had an accompanying epithelial defect (p = 0.041). After the Nd:YAG laser treatment or conservative treatment, 64.1% and 60.5% of the eyes, respectively, remained free from recurrence 1 year after treatment, however the success rate decreased over time (p = 0.649). The final visual acuity in the group that received Nd;YAG laser treatment was 0.05 +/- 0.06 log MAR and 0.09 +/- 0.08 log MAR (p = 0.649) in the group that received conservative management. None of the patients in either group experienced complications of corneal scarring. CONCLUSIONS: The difference in the recurrence rates between Nd:YAG laser treatment and conservative treatment were not statistically different, however, the severity of recurred episodes were milder in the eyes that received Nd:YAG laser treatment.