J Korean Ophthalmol Soc.  2017 May;58(5):503-508. 10.3341/jkos.2017.58.5.503.

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

• Shin DY
• Chung SH

• KMID: 2378619
• DOI: http://doi.org/10.3341/jkos.2017.58.5.503

Abstract

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.

Keyword

Anterior stromal puncture; Hyperosmotic agent; Recurrent corneal erosion

MeSH Terms

Corneal Injuries
Corneal Opacity
Follow-Up Studies
Glare
Humans
Inflammation
Ophthalmic Solutions*
Punctures*
Recurrence
Refractive Surgical Procedures
Retreatment
Retrospective Studies
Ophthalmic Solutions

Figure

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  Figure 1 Age and gender distribution at the time of diagnosis of recurrent corneal erosion. There was no differences between genders.

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  Figure 2 Number of previous recurrence in 21 eyes of 21 patients with recurrent corneal erosion.

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  Figure 3 Previous therapies in 21 eyes of 21 patients with recurrent corneal erosion. All 21 eyes had conservative treatment with eye drops and 3 eyes had anterior stromal puncture at other hospitals.

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  Figure 4 Gross image of 26-Gauge needle used in anterior stromal puncture. The surgeon can bend the disposable 26-Gauge needle using a microneedle holder.

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