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Corneal erosions for over 10 yrs
mike_1974 posted:
Hi- my eye doc wants to give me a diamond burr superficial keratectomy to treat recurring erosions in both my eyes. i am sick of this debilitating condition and want it gone but i am worried about this procedure. is it safe and can it cause any permanent damage or loss of vision? Are there any alternative treatments to this? thanks for your help
Alan M Kozarsky, MD responded:
Sorry that you are having problems. Recurrent corneal erosions are a particularly uncomfortable (painful) condition.

When an erosion (spontaneous abrasion) condition involves only one eye, it is usually due to an injury which never completely healed. When both eyes are involved, it is likely due to to an inherited condition which we call map/dot/fingerprint or epithelial basement membrane dystrophy. In either situation, the surface cells have poor attachment to the corneal substance and "flake off". When this occurs, the corneal nerves are exposed and the pain occurs.

The first line of treatment is generally lubrication and especially the use of concentrated saline ointment (Muro 128). A thin bandage contact lens can be used as well. When medical measures fail, the loose and poorly adherent cells can be removed....actually causing a corneal abrasion with the expectation that the healed area will be more sturdy and less likely to flake off.

The cell removal is sometimes combined with a method to "rough up" the underlying corneal substance with the expectation that better adherence will take place after healing. This can be done with a diamond burr or a LASIK type laser. Or simply wiping off the poorly attached epithelial cells with dull blade can also work.

The success rate is rather high and the chance of complications such as infection is remotely low. The recovery is not instantaneous and it takes weeks for the corneal surface to stabilize. For this reason we often do one eye at a time.

Freedom from recurrent erosions is a worthy goal even if the treatment involves weeks of recovery.

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