Abstract
OBJECTIVES: To evaluate the efficacy and safety of full corneal epithelial debridement (FCED) combined with local corticosteroids for recurrent corneal erosion (RCE), and to monitor corneal healing using in vivo confocal microscopy (IVCM). METHODS: This prospective study included 65 eyes from 65 patients with RCE who failed conventional treatments between May 2022 and July 2024. Data were collected via chart review and telephone surveys. Outcome measures included demographics, aetiology, symptom duration/recurrence, additional treatments, and complications. IVCM was performed pre-FCED and at 2 weeks, and 1, 3, and 6 months post-FCED. RESULTS: The study involved 28 males and 37 females with a mean age of 37.7 years. The primary cause was trauma (90.8%). Mean follow-up was 19.8 months. Mean best-corrected visual acuity (BCVA) improved from 0.29 pre-operatively to 0.11 post-operatively (p < 0.05). After 7 months, 71% of eyes showed complete resolution; after 1 year, the effective rate was 70%. Pain relief was reported in 97% of eyes after 3 days. Complications included elevated intraocular pressure in 2 patients and grade 2 haze in 1. Recurrence occurred in 29% of eyes, mostly within 3 months. IVCM revealed complete corneal epithelial repair by 2 weeks, but inflammatory cells persisted for up to 12 months, and sub-basal nerve regeneration was a lengthy process. CONCLUSIONS: FCED with corticosteroids effectively alleviates symptoms and prevents recurrence in RCE. IVCM provides valuable insights into the healing process, confirming treatment efficacy. Adequate corticosteroid treatment is crucial to manage inflammatory responses and prevent recurrence.