Micropunciones del estroma anterior corneal como tratamiento de la erosión corneal recidivante

Résumé

SUMMARY Purpose Assess the efficacy of corneal anterior stromal punctures as treatment for Recurrent Corneal Erosion (RCE) and relapse prevention. Two other treatments are compared: simple occlusion with antibiotic ointment, not manipulating the lesion and debridement of erosion previous to occlusion. Material and Method A retrospective study was performed on a total of 36 patients diagnosed with RCE where cases underwent different treatments and results were compared. Other general factors influencing the evolution of the illness are evaluated as well. Results No statistically significant differences were found comparing the effectiveness of these three treatments to decrease the risk of relapses in erosion. Presence of signs of map-dot-fingerprint dystrophy is common in RCE patients, however not associated with higher risk of relapse. The most frequent associated alteration is meibomitis. Conclusions Treatment of RCE with erosion debridement previous to occlusion results in a high rate of healing and this treatment seems better than stromal punctures since it implies less potential risks. Pathogenesis of RCE still remains obscure. Association with certain dystrophys of the epithelial basal membrane could not be demonstrated in this study. However, it is possible that the presence of meibomitis, associated with lids contamination by certain strains of staphylococcus aureus, may play an important role in RCE pathogenesis (Arch Soc Esp Oftalmol 2002; 77: 257-262).