Messina Marco, Giannaccare Giuseppe, Cagini Carlo, Fogagnolo Paolo, Poddi Maria, Bonifazi Tommaso, Mirabella Giuseppe, Coco Giulia, Della Lena Francesco
Department of Medicine and Surgery, Ophthalmology Section, S. Maria della Misericordia Hospital, University of Perugia, 06132 Perugia, Italy.
Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09127 Cagliari, Italy.
J Clin Med. 2025 Mar 28;14(7):2342. doi: 10.3390/jcm14072342.
: Epithelial basement membrane dystrophy (EBMD) is a common corneal dystrophy characterized by recurrent corneal erosions and visual impairments due to surface irregularities and opacities. This study aims to evaluate the effectiveness of alcohol-assisted delamination (ALD) of the corneal epithelium in patients with EBMD affecting the visual axis, who experience decreased vision quality due to higher-order aberrations (HOAs) and irregular astigmatism. : Eleven eyes of nine patients (four males and five females) were treated with ALD, with a mean age of 51.3 ± 19.7 years. All patients underwent refraction, best-corrected visual acuity (BCVA) assessment, a comprehensive slit-lamp examination for EBMD pattern identification, anterior segment imaging with and without fluorescein, tear break-up time (BUT) testing, corneal topography, corneal aberrometry (Zernike coefficients (Znm) were calculated for a 5.0 mm simulated pupil), and anterior segment optical coherence tomography preoperatively and at 1-day, 14-day, 1-month, 3-month, 6-month, and 12-month intervals. : All patients demonstrated improvements in BCVA and visual quality, ocular comfort, and BUT results. The mean root mean square (RMS) value of total corneal aberrations decreased from 1.72 ± 0.90 μm to 0.90 ± 0.62 μm, while the mean RMS value of HOAs reduced from 0.92 ± 0.48 μm to 0.53 ± 0.28 μm. Astigmatism and trefoil were the aberration components that exhibited the most significant reductions. : Alcohol-assisted delamination of the corneal epithelium is a safe and effective treatment for central EBMD patients experiencing visual quality deterioration. Astigmatism and trefoil appear to be the primary aberrations contributing to visual disturbances in this patient population.
上皮基底膜营养不良（EBMD）是一种常见的角膜营养不良，其特征为由于角膜表面不规则和混浊导致反复角膜糜烂和视力损害。本研究旨在评估酒精辅助角膜上皮分层术（ALD）对影响视轴的EBMD患者的有效性，这些患者因高阶像差（HOAs）和不规则散光而视力质量下降。9例患者（4例男性和5例女性）的11只眼睛接受了ALD治疗，平均年龄为51.3±19.7岁。所有患者术前以及术后1天、14天、1个月、3个月、6个月和12个月均接受了验光、最佳矫正视力（BCVA）评估、用于识别EBMD模式的全面裂隙灯检查、有无荧光素的眼前节成像、泪膜破裂时间（BUT）测试、角膜地形图、角膜像差测量（针对5.0mm模拟瞳孔计算泽尼克系数（Znm））以及眼前节光学相干断层扫描。所有患者的BCVA、视觉质量、眼部舒适度和BUT结果均有改善。角膜总像差的平均均方根（RMS）值从1.72±0.90μm降至0.90±0.62μm，而HOAs的平均RMS值从0.92±0.48μm降至0.53±0.28μm。散光和三叶草像差是减少最为显著的像差成分。酒精辅助角膜上皮分层术是治疗视力质量恶化的中央型EBMD患者的一种安全有效的方法。散光和三叶草像差似乎是导致该患者群体视力障碍的主要像差。
