Superior Perilimbal Epitheliopathy in Recurrent Corneal Erosion Syndrome.

PURPOSE

To highlight the finding of occult areas of poor epithelial adhesion in the superior perilimbal cornea in a minority of patients with recalcitrant recurrent corneal erosion syndrome presenting with corneal erosion elsewhere on the corneal surface.

PATIENT POPULATION

Thirty-one eyes of 31 consecutive patients with corneal erosion undergoing mechanical debridement of the epithelium before diamond burr keratectomy for recurrent corneal erosion.

METHODS

Thirty-one eyes of 31 consecutive patients with recurrent corneal erosion were examined for poor epithelial adhesion determined by mechanical debridement with a dry microsponge.

RESULTS

During debridement, 8 of 31 eyes (25.8%) displayed a large arcuate area of occult dysfunction of adhesion in the superior perilimbal area. None of these eyes showed recurrence over a mean of 18 months after diamond burr keratectomy (95% confidence interval, 0%-36.9%).

CONCLUSIONS

Mechanical debridement with a microsponge identified a significant minority of patients with poor adhesion in the superior perilimbal cornea away from the area of obvious erosion and increased the target area for diamond burr keratectomy. This 2-pronged approach allowed successful management of this group.