A randomised controlled trial of alcohol delamination and phototherapeutic keratectomy for the treatment of recurrent corneal erosion syndrome

Abstract

Aim: To compare the efficacy of alcohol delamination (ALD) and phototherapeutic keratectomy (PTK) for the treatment of recurrent corneal erosion syndrome (RCES) in a prospective, randomised, controlled trial.

Methods: Patients with RCES not responding to conservative treatment were recruited and randomised to undergo ALD or PTK. Patients were masked to their treatment group. The primary outcome measure was the intensity of pain on waking, using a numerical rating scale between 0 and 10 to record a subjective pain score.

Results: 17 eyes were treated with ALD and 16 eyes were treated with PTK. The mean follow-up period was 16.25 and 17.25 months, respectively. There were no differences in baseline parameters or pain scores at 3, 6, 12 and 24 months between the groups. The pain score improved from baseline at 3 months (ALD, p=0.022; PTK, p=0.014) and 6 months (ALD, p=0.033; PTK, p=0.036) in both groups, but only in the ALD group at 24 months (ALD, p=0.035; PTK, p=0.500). Overall, there was complete or partial resolution of symptoms in 11 (65%) eyes in the ALD group and 10 (63%) eyes in the PTK group. Recurrence of symptoms was observed in five eyes in the ALD group and six eyes in the PTK group. There was one treatment failure in the ALD group. There were no long-term complications.

Conclusions: ALD should be considered as an alternative treatment for the management of RCES with promising results compared with PTK.

Keywords: Cornea.