Polishing of bowman’s membrane with diamond burr in the treatment of recurrent corneal erosion syndrome

Abstract

Purpose — to study the effectiveness of polishing Bowman’s membrane with a diamond burr (DBPBM) in the treatment of recurrent corneal erosion syndrome (RCES). Material and methods. The study included 22 patients (22 eyes) with RCES aged 20—56 years who underwent our original modification of DBPBM. All patients had keratotopography examined, endothelial cell density measured, and optical coherence tomography (OCT) of the cornea taken before and after the procedure. Additionally, conjunctival scraping, blood test for types I and II herpes (fluorescent antibody method) were performed before the surgery. Post-operative treatment included 1—2 weeks of anti-inflammatory and anti-bacterial steroid therapy, and 6 months of artificial tear Cationorm usage. Results. Rehabilitation of all patients after the procedure went quickly, and no relapses were noted during the follow-up. Complete epithelialization of the area of surgical intervention under soft contact lens occurred over 2—3 days. Epithelial thickness was measured with OCT including epithelial mapping; after the surgery, it was almost even over the entire corneal surface. No complications such as induced post-operative refractive error or corneal haze were registered during the course of the study. Disruption of basal epithelial layer and epithelial basal membrane in the area of erosion relapse detected with scanning electron microscopy confirmed the need for their removal in the course of the surgery. Conclusion. Conservative treatment of RCES rarely yields results. Removal of inadequate epithelium and following DBPBM using our original method is a highly effective and accessible procedure for RCES treatment with low risk of complications and relapse.