Effects of Diamond Burr in Patients with Recurrent Corneal Erosion

Hyun Ju Kim; Jae Wong Koh

doi:10.3341/jkos.2018.59.8.711

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Kim and Koh: Effects of Diamond Burr in Patients with Recurrent Corneal Erosion

Original Article

J Korean Ophthalmol Soc 2018;59(8):711-717.

Published online: 25 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.8.711

Effects of Diamond Burr in Patients with Recurrent Corneal Erosion

Hyun Ju Kim, MD, Jae Wong Koh, MD, PhD

Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea

Address reprint requests to Jae Wong Koh, MD, PhD Department of Ophthalmology, Chosun University Hospital, #365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea Tel: 82-62-220-3190, Fax: 82-62-225-9839 E-mail: ophkoh@hanmail.net

Received 15 March 2018 Revised 21 May 2018 Accepted 20 July 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study is to evaluate the recurrence rate and treatment effect of conservative treatment and surgical treatment with diamond burr in reccurent corneal erosion.

Methods

Between January 2010 and October 2017, 67 patients who were diagnosed with repeated corneal erosion, 55 patients underwent conservative treatment and 12 patients underwent surgical treatment with a diamond burr were evaluated for the duration of previous treatment, recurrence frequency, symptom severity, visual acuity, and the effect of treatment depending on recurrence. Surgical treatment was performed when corneal epithelial loosening occurred in more than 10% of the cases and the patient required surgical treatment. Conservative treatment was continued in patients who did not want surgical treatment.

Results

There were no differences in the mean age, sex, recurrence frequency, symptom severity, and duration of treatment. All 67 patients were unilateral, and 55 patients underwent conservative treatment. Of these, 23 patients (41.8%) showed improvement, and 32 patients relapsed within 6 months. Ten eyes (83.3%) of 12 eyes treated with a diamond burr showed improvement and two eyes recurred within 6 months. The recurrence rate was lower in the diamond burr group than in the conservative group (p = 0.011). In comparison with diamond burr and conservative treatment, the visual acuity of the diamond burr group improved statistically significantly compared to the group with conservative treatment (p = 0.002).

Conclusions

In patients with recurrent corneal erosion, surgical treatment with diamond bur was effective in improving visual acuity and preventing recurrence of recurrent corneal erosion than conservative treatment.

Keywords: Diamond burr, Recurrent corneal erosion

References

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Figure 1.

Gross image of diamond burr. The diamond burr tip used in superficial keratectomy.

Figure 2.

Combined ocular disease in RCE. Combined ocular disease at the time of diagnosis of recurrent corneal erosion. RCE = recurrent corneal erosion; DES = dry eye syndrome; MGD = meibomian gland disease.

Figure 3.

Causative factors. Causative factors in 67 eyes of 67 patients with recurrent corneal erosion. RCE = recurrent corneal erosion.

Figure 4.

Comparison of surgical and conservative treatment. A comparison of the recurrences between the surgical treatment with diamond burr group and conservative treatment group.

Table 1.

Demographic data of recurrent corneal erosion patients about age, previous recurrences, symptom severity, and duration of previous treatment

	Surgical therapy		Conservative therapy		t	p-value^*
	Mean	S.D.	Mean	S.D.	t	p-value^*
Age	42.67	10.990	46.60	14.836	−0.866	0.390
Previous recurrences Symptom severity^36–37(stage1–4)	2.42 1.75	1.730 0.754	3.58 1.73	5.597 0.706	−0.710 0.100	0.480 0.921
Previous treatment period (mo.)	10.17	4.549	13.91	21.391	−0.600	0.551

S.D. = standard deviation; mo. = months.

^* t-test, p < 0.05, p < 0.01.

Table 2.

The best corrected visual acuity before treatment and after 6 months of treatment with diamond burr and conservative treatment group

	Surgical therapy		Conservative therapy		t	p-value^†
	Mean	S.D.	Mean	S.D.	t	p-value^†
At the time of diagnosis (V/A)	0.71	0.204	0.55	0.346	1.542	0.128
After 6 months (V/A)	0.95	0.090	0.81	0.259	3.250	0.002^*

There was no statistically significant difference in visual acuity between the two groups at the first visit (p = 0.128). After 6 months, statistically significant improvement in visual acuity in the surgical treatment group (p = 0.002).

S.D. = standard deviation; V/A = visual acuity.

^* p < 0.05

^† t-test.

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