PURPOSE: To investigate the efficacy of alcohol delamination in the management of recurrent corneal erosions (RCEs). DESIGN: Prospective single-center consecutive descriptive case series. PARTICIPANTS: Twelve patients with RCEs who did not respond to conservative management were treated with alcohol delamination. METHODS: A consecutive case series of 12 patients with RCEs who did not respond to conservative management were treated by alcohol delamination. A pain score was generated based on a visual analog scale of pain intensity. The duration of pain and frequency were also recorded. Patients were followed up at 1 week, 4 weeks, 3 months, 6 months, and 1 year and then at yearly intervals and monitored for recurrence of symptoms and corneal morphology. The removed epithelial sheet was examined by electron microscopy in 4 patients. INTERVENTION: The affected area of epithelium was peeled off after an application of 20% alcohol for 40 seconds under topical anesthesia. Eyes of patients were treated with an antibiotic and preservative-free artificial tear medication, and a bandage contact lens was inserted until epithelial healing was complete. MAIN OUTCOME MEASURES: Frequency of recurrence of erosions and duration and intensity of symptoms after alcohol delamination were studied. RESULTS: Eleven of the 12 eyes of patients had dramatic relief of symptoms over the follow-up period, ranging from 6 to 40 months. Eight patients were symptom free, and 1 patient had 2 mild symptom episodes in the first posttreatment month before becoming symptom free. The average follow-up period was 23.5 months. There were no residual effects from the application of alcohol noted in any patient. Electron microscopy of removed epithelium showed features of the underlying pathology. The separation of the epithelium occurred at the interface of the subepithelial abnormal deposit and the surface of Bowman's zone. CONCLUSION: Alcohol delamination appears to be a novel, simple, inexpensive treatment for RCEs. Unlike other methods, the removed epithelium is available as a sheet that may be subjected to further examination, though some of the changes observed may reflect the effect of alcohol on the epithelium.
PURPOSE: To investigate the efficacy of alcohol delamination in the management of recurrent corneal erosions (RCEs). DESIGN: Prospective single-center consecutive descriptive case series. PARTICIPANTS: Twelve patients with RCEs who did not respond to conservative management were treated with alcohol delamination. METHODS: A consecutive case series of 12 patients with RCEs who did not respond to conservative management were treated by alcohol delamination. A pain score was generated based on a visual analog scale of pain intensity. The duration of pain and frequency were also recorded. Patients were followed up at 1 week, 4 weeks, 3 months, 6 months, and 1 year and then at yearly intervals and monitored for recurrence of symptoms and corneal morphology. The removed epithelial sheet was examined by electron microscopy in 4 patients. INTERVENTION: The affected area of epithelium was peeled off after an application of 20% alcohol for 40 seconds under topical anesthesia. Eyes of patients were treated with an antibiotic and preservative-free artificial tear medication, and a bandage contact lens was inserted until epithelial healing was complete. MAIN OUTCOME MEASURES: Frequency of recurrence of erosions and duration and intensity of symptoms after alcohol delamination were studied. RESULTS: Eleven of the 12 eyes of patients had dramatic relief of symptoms over the follow-up period, ranging from 6 to 40 months. Eight patients were symptom free, and 1 patient had 2 mild symptom episodes in the first posttreatment month before becoming symptom free. The average follow-up period was 23.5 months. There were no residual effects from the application of alcohol noted in any patient. Electron microscopy of removed epithelium showed features of the underlying pathology. The separation of the epithelium occurred at the interface of the subepithelial abnormal deposit and the surface of Bowman's zone. CONCLUSION:Alcohol delamination appears to be a novel, simple, inexpensive treatment for RCEs. Unlike other methods, the removed epithelium is available as a sheet that may be subjected to further examination, though some of the changes observed may reflect the effect of alcohol on the epithelium.
Authors: Sonali Pal-Ghosh; Ahdeah Pajoohesh-Ganji; A Sue Menko; Hye-young Oh; Gauri Tadvalkar; Daniel R Saban; Mary Ann Stepp Journal: Invest Ophthalmol Vis Sci Date: 2014-04-28 Impact factor: 4.799
Authors: Ravinder P Singh; Dev Raj; Anupama Pherwani; Ruby Lagnado; Asiya Abedin; Habibullah Eatamadi; Manu Mathew; Harminder S Dua Journal: Br J Ophthalmol Date: 2007-02-14 Impact factor: 4.638
Authors: Mi Yeon Song; Jae Lim Chung; Kook Young Kim; Kyu Yeon Hwang; Young A Kwon; Sang Wroul Song; Byung Yeop Kim; Kyungmin Koh Journal: Korean J Ophthalmol Date: 2020-08