Baylor School, Chattanooga, TN.
Professional Eye Associates, Dalton, GA; and.
Cornea. 2022 Oct 1;41(10):1248-1254. doi: 10.1097/ICO.0000000000002963. Epub 2022 Mar 17.
The purpose of this study was to evaluate the incidence and epidemiology of recurrent corneal erosion within a clinical population using standard diagnostic techniques and a new technique called the corneal sweep test (CST).
A retrospective chart review was conducted on 58 eyes of 51 patients with the diagnosis of recurrent corneal erosion from July 2018 to June 2020. All underwent a thorough history and physical examination. The CST was performed as a confirmatory test and on any patient who lacked visible corneal pathology.
The CST was necessary on 49 of the 58 eyes to help confirm the diagnosis of a corneal erosion. Among them, 34 had an occult corneal erosion, which is defined as having a normal-appearing cornea on slitlamp examination but found to have loose corneal epithelium with the CST. Clear corneal cataract surgery (28 eyes, 48.2%) was the most common presumed mechanism of injury, with 20 (71.4%) developing symptoms only after cataract surgery. All 20 eyes had an erosion located directly over a clear corneal cataract incision.
The CST is a new and effective technique to help diagnose corneal erosions in the absence of visible corneal findings. Clear corneal cataract surgery is an under-recognized but important risk factor to consider because the incision can be the source for an erosion. Using the CST could lead to a paradigm shift in the way clinicians approach RCEs and patients with a persistent ocular pain syndrome.
本研究旨在使用标准诊断技术和一种名为角膜清扫试验(CST)的新技术,评估临床人群中复发性角膜糜烂的发生率和流行病学。
对 2018 年 7 月至 2020 年 6 月期间诊断为复发性角膜糜烂的 51 例 58 只眼的患者进行回顾性图表审查。所有患者均接受了详细的病史和体格检查。CST 作为确诊试验和任何缺乏可见角膜病变的患者进行。
为了帮助确诊角膜糜烂,有 49 只眼(58 只眼中的 49 只)需要进行 CST。其中,34 只眼存在隐匿性角膜糜烂,定义为裂隙灯检查时角膜外观正常,但 CST 显示角膜上皮疏松。透明角膜白内障手术(28 只眼,48.2%)是最常见的假定损伤机制,其中 20 只眼(71.4%)仅在白内障手术后出现症状。所有 20 只眼的糜烂均位于透明角膜白内障切口的正上方。
CST 是一种新的有效技术,可在缺乏可见角膜发现的情况下帮助诊断角膜糜烂。透明角膜白内障手术是一个被低估但重要的考虑因素,因为切口可能是糜烂的来源。使用 CST 可能会导致临床医生治疗 RCE 和持续性眼部疼痛综合征患者的方法发生范式转变。