We read with great interest the article titled “Demographic Patterns and Treatment Outcomes of Patients with Recurrent Corneal Erosions Related to Trauma and Epithelial and Bowman Layer Disorders.” We applaud the issue of recurrent corneal erosion. We wish to highlight a few points in the study.
It would be useful to know whether the authors have included eyes with endothelial dysfunctions, eyes with severe dry eye, and eyes of diabetic patients giving rise to recurrent corneal erosion. Further, the authors reported that a history of trauma was solely responsible for recurrent corneal erosion in 25.7% of total reported eyes and another 7.7% of eyes with epithelial basement membrane dystrophy with additional trauma. However, there is no mention about the level of trauma, specifically with regard to corneal structural involvement, anywhere in the article.
In the management of patients, the authors explain that in addition to medical therapy and surgical management, patients were treated with epithelial debridement, either with or without diamond burr polishing, anterior stromal puncture, and phototherapeutic keratectomy. They observed that diamond burr polishing is the most common surgical management with encouraging results, which is very interesting. It is in fact a very simple procedure, and it not only provides good outcome in terms of visual acuity, but also reduces the rate of recurrence. In our opinion, a brief description on its method of action would have been of clinical importance. Further, the authors did not mention the surface coverage after the technique, which should have been made clear.
We have carried out a comparative study in 30 eyes with recurrent corneal erosion of different causes to see the effect of amniotic membrane transplant (AMT) following the technique. The eyes were divided into two groups. In 15 eyes, after recurrent corneal erosion removal, no surface coverage was offered and in rest 15 eyes the surface was covered with amniotic membrane (AM). All the eyes received 3% ciprofloxacin dropQID, tear substitute 2 hourly and fluoromethalone drop (1%) BID. We found the post operative haze was reduced when the surface was covered with AM. However, as the number of eyes were few, no statistical analysis was carried out. We would like to know from the authors if they have some experience on it so that a large cohort comparative study would make us wiser.
Once again we congratulate the authors for bringing this common and important issue to light.