SHOULD WE PATCH CORNEAL EROSIONS

Objective: To study the effect of patching on the speed of reepithelia lization, slit-lamp signs of epithelial wound healing, and patient dis comfort following a corneal abrasion. Methods: Forty-eight eyes of 46 patients with corneal erosion sparing Bowman membrane were randomized into 2 groups: with or without patching. Slit-lamp examination and pho tographs of the fluorescein-stained cornea were performed on a daily b asis until reepithelialization was complete. Photographs were analyzed using computer-assisted planimetry. Results: No statistically signifi cant difference was found between patched (n=25) and nonpatched (n=22) eyes for the mean size of the initial erosion (patched eyes, 23.7 mm( 2); nonpatched eyes, 18.9 mm(2); P=.42), linear speed of reepitheliali zation (reduction over time of the radius of the largest circle includ ed in the erosion. patched eyes, 0.0375 mm/h; nonpatched eyes, 0.0353 mm/h; P=.78), and surface speed of reepithelialization (reduction over time of the erosion area:patched eyes, 0.6510 mm(2)/h; nonpatched eye s, 0.5657 mm(2)/h; P=.60). The power to detect a 12-hour delay of epit helial closure was 95%. There were no significant differences between the 2 groups for pain, analgesia, insomnia, aspect of the epithelial b order, intensity and duration of stromal edema, Descemet folds, anteri or uveitis, and filaments. Conclusions: Patching a corneal erosion doe s not significantly accelerate reepithelialization and does not alter the epithelial wound healing pattern. It does not reduce the incidence and severity of inflammation nor relieve pain when compared with trea tment without patching.