Epithelial Debridement and Bowman's Layer Polishing for Visually Significant Epithelial Irregularity and Recurrent Corneal Erosions
Epithelial Debridement and Bowman's Layer Polishing for Visually Significant Epithelial Irregularity and Recurrent Corneal Erosions
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DOI：
10.1097/ico.0b013e3181a166b9
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发表时间：
2009-12-01
期刊：
影响因子：
2.8
通讯作者：
Yu, Fei
中科院分区：
文献类型：
--
作者：
Aldave, Anthony J.;Kamal, Khairidzan M.;Yu, Fei
目的：报告Bowman层上皮清创和金刚石磨头抛光的效用（艾德+ DBP）治疗复发性角膜糜烂和与上皮基底膜营养不良（EBMD）相关的视觉上显著的上皮不规则。设计：回顾性干预性连续病例系列参与者：所有患者均在2002年11月1日至2008年11月1日期间由同一外科医生进行艾德+ DBP。方法：收集与EBMD相关的症状的频率和严重程度以及既往治疗的数据。还记录了有关手术和术后病程的详细信息。治疗后视力改善的意义采用Wilcoxon符号秩检验确定。主要结果测量：治疗后视力和复发性圆锥形糜烂的变化，结果：艾德+ DBP在72个月期间进行审查的56只眼睛（42例）。在56只眼睛中，37只（66%）接受了复发性角膜糜烂治疗，22只（39%）接受了视觉显著上皮不规则治疗（3只眼睛接受了两种情况的治疗）。46眼（82%）诊断为EBMD，9眼（16%）有角膜外伤史。视力显著改善（P = 0.016），治疗前有角膜糜烂病史的25只眼中，有24只眼（96%）治疗后复发性角膜糜烂消退，随访时间超过3个月（平均18.9个月;范围3.5-66.5个月）。视力显著改善（P = 0.004），所有14只因视觉显著EBMD治疗的眼睛中与上皮不规则相关的视觉像差均得到解决，随访时间超过3个月（平均14.2个月;范围3.4-50.8个月）。轻度，中央角膜上皮下混浊的47只眼睛，没有表现出上皮下混浊前艾德+ DBP，虽然它是不相关的视力下降，在最后一次随访vision.Conclusions：艾德+ DBP是一种安全有效的技术，在管理复发性角膜糜烂和视觉上显着的上皮不规则与EBMD。
Purpose: To report the utility of epithelial debridement and diamond burr polishing of Bowman's layer (ED + DBP) in the management of recurrent corneal erosions' and visually significant epithelial irregularity associated with epithelial basement membrane dystrophy (EBMD).Design: Retrospective interventional consecutive case seriesParticipants: All patients who underwent ED + DBP by a single surgeon between November 1, 2002 and November 1, 2008.Methods: Data were collected regarding the frequency and severity of symptoms associated with EBMD as well as previous treatments. Details regarding the procedure and the postoperative course were recorded as well. The significance of the improvement in visual acuity after treatment was determined using Wilcoxon signed rank test.Main Outcome Measures: Change in Visual acuity and recurrent conical erosions after treatment,Results: ED + DBP was performed on 56 eyes (42 patients) during the 72-month period under review. Of the 56 eyes, 37 (66%) were treated for recurrent corneal erosions and 22 (39%) were treated for visually significant epithelial irregularity (3 eyes were treated for both conditions). EBMD was diagnosed in 46 eyes (82%), and a history of corneal trauma was elicited in 9 eyes (16%). Visual acuity improved significantly (P = 0.016), and recurrent corneal erosions resolved after treatment in 24 (96%) of the 25 eyes with a history of corneal erosions before treatment with more than 3 months of follow-up (average, 18.9 months; range, 3.5-66.5 months). Visual acuity improved significantly (P = 0.004), and visual aberrations related to epithelial irregularity resolved in all 14 eyes treated for visually significant EBMD with more than 3 months of follow-up (average, 14.2 months; range, 3.4-50.8 months). Mild, central subepithelial corneal haze developed in 12 (26%) of the 47 eyes that did not demonstrate subepithelial haze before ED + DBP, although it was not associated with decreased vision at the last follow-up visit in any patient.Conclusions: ED + DBP is a safe and effective technique in the management of recurrent corneal erosions and visually significant epithelial irregularity associated with EBMD.