THE NATURAL-HISTORY AND MANAGEMENT OF RECURRENT CORNEAL EROSION - A PROSPECTIVE RANDOMIZED TRIAL

One hundred and seventeen patients with a history of recurrent corneal erosion were recruited at initial hospital presentation. Seventy-five cases had a history of shallow corneal injury, 23 had eptithelial bas ement membrane dystrophy (EBMD), 8 had both and 11 had neither. Mean a ge at presentation was 38 years and follow-up ranged from 6 to 16 mont hs (measn 10.6 months). Sixty-one patients presented with a first acut e corneal erosion, 21 with a subsequent acute corneal erosion and 35 w ith chronic symptoms. Patients with EBMD or a trauma-related focal epi thelial basement membrane abnormality were more likely to present with chronic recurrent symptoms than trauma-related cases with no abnormal ity on examination. Both EBMD and trauma-related cases typically recur red in the lower half of the cornBa, frequently in the midline (z = 7. 3, p < 0.001), suggesting an intrinsic or acquired abnormality of the epithelial basement membrane at this site. Only four 82 acute episodes did not resolve by 5 days with simple patching, cycloplegia and topic al anbibotic ointment. In the vast majorityf of patients presenting wi th an acute erosion, simple management measures only are required. Of 117 cases started on prophylactic ointment at night, further therapy d ue to prophylaxis failure was required in only 5. EBMD was a risk fact or for failure (relative risk 10.77). There was no difference in efica cy between once daily prophylactic paraffin and hypertonic saline oint ments (p = 0.17), suggesting they both have only a lubricant action.