Anterior Stromal Puncture for Treatment of Recurrent Corneal Erosion Syndrome: Patient Clinical Features and Outcomes
Narrative Responses:
Purpose
To evaluate the clinical features and outcomes of patients with recurrent corneal erosion syndrome who underwent anterior stromal puncture.
Methods
Retrospective, non-randomized, consecutive case series. Database search of patients from 2003 to 2013 who underwent anterior stromal puncture was conducted at a tertiary care hospital cornea clinic. Charts of 30 patients (35 eyes) were reviewed. Outcome measures included patient demographics, laterality, history of corneal trauma, prior ocular history, frequency and duration of symptoms, failed treatments, signs on slit lamp examination, degree of symptom resolution, additional treatments after anterior stromal puncture, and complications.
Results
Mean age at presentation was 37 (+/- 11.5 SD) years, 60% were males. 83.3% of patients had unilateral involvement, 16.7% had bilateral involvement. 62.9% of eyes had a prior history of corneal trauma, 2.9% had prior LASIK. 97% of eyes had symptoms of pain upon awakening. Mean follow up time was 12 months (range of 3-60 months). 62.9% of eyes were asymptomatic at final follow-up and 37.1% of eyes experienced milder episodes. 17% of eyes required additional treatment: 16.6% had superficial keratectomy, 66% had repeat anterior stromal puncture and 16.7% had PTK. No complications were observed.
Conclusion
Anterior stromal puncture using a short (5/8 inch) 25 gauge bent needle is a simple, safe, and cost-effective procedure for symptomatic relief in patients with recurrent corneal erosion syndrome refractive to conservative measures. Repeat anterior stromal puncture may be performed prior to additional surgical intervention.