Oculase Articles

What are the treatment options for recurrent corneal erosion syndrome?

Mr Tariq Ayoub - 8 Dec 2022

Recurrent corneal erosion can cause severe pain and other uncomfortable symptoms. Our highly-trained specialist will work with you to provide the most suitable treatment plan, updating it as required for your condition. 

 

Recurrent corneal erosion treatment

Treatment for recurrent corneal erosion (RCE or RCES) aims to reduce friction between your eyes and eyelids and encourage epithelial healing. Our secondary aim is to prevent future episodes. We can split treatment for RCE into two categories: medical and surgical. 

Our first line of treatment is usually medical. However, we may recommend surgery if you come to our clinic for a second opinion after previous medical treatment. At Oculase, we assess each individual based on their circumstances and tailor our treatment plans to you.

 

Medical treatment

RCE often resolves with medical treatment. We recommend surgery when medical treatment has been unsuccessful, as we don’t want to put you through any unnecessary procedures.

Medical options include:

  • Lubricant ointment during the day and eye drops at night
  • Antibiotic eye drops and pain relief
  • Punctal occlusion using punctal plugs
  • Soft bandage contact lens
  • Topical corticosteroids

Treatment starts with lubricating ointment and eye drops; these can also help prevent future flare-ups. Our eye specialist will let you know when and how to apply them. 

RCE treatment may occur over months or years before your eyes heal fully, which you may find frustrating. Remember to attend regular follow-up appointments so we can monitor your progress and alter your treatment plan as necessary.

 

Surgical treatment options

Alcohol delamination

There are five layers of the cornea. During alcohol delamination, we remove the damaged outer layer (the corneal epithelium). This allows healthy tissue to regrow. We apply alcohol for 30 seconds to the corneal surface, softening it so our surgeon can gently take it out. Then we’ll cover your eye with a bandage contact lens to help it heal and increase your comfort.

Epithelial debridement

Another way we can remove your corneal epithelium is with epithelial debridement. During epithelial debridement, we mechanically remove the loose and nonadherent epithelium. To do so, we may use a surgical sponge. You also need a bandage contact lens for between a few days and up to two weeks after the procedure.

Phototherapeutic keratectomy (PTK)

PTK laser surgery involves using an excimer laser to remove the epithelium (the first layer of the cornea), and ablate and polish the Bowman’s layer. The Bowman’s layer, also known as the Bowman’s membrane, is the second of the five corneal layers after the epithelium. We may use alcohol or mechanically remove the loose epithelial layer.

When your epithelial layer regrows, it should have stronger adhesion to the Bowman layer. After the procedure, we will place a bandage contact lens over your eye.

Cornea structure to understand recurrent corneal erosion treatment better

How do you know when it’s time for RCE surgery?

We recommend PTK when other treatment options for RCE have not worked. Our specialist may recommend the procedure once you are suitable for it. This might be if you frequently experience symptoms that disrupt your daily activities despite using lubricants. 

Speak to our ophthalmologist about your suitability for PTK surgery. Mr Tariq Ayoub will provide a thorough consultation, including a complete assessment of your eyes. We may also perform scans to determine which layers of your cornea are affected.

 

Preventing recurrence

Using lubricating ointments and eye drops long-term can help prevent a recurrence. You should also avoid rubbing your eyes. Our specialist may recommend increasing your use of lubricants depending on the severity of your symptoms. If you need surgery, PTK has a low recurrence rate. It’s a highly safe and effective procedure with few side effects.

 

Private RCE treatment at Oculase

We offer many treatment options for recurrent corneal erosion, medical and surgical. If you have RCE and experience frequent symptoms, our expert ophthalmologists can help. We’ll regularly assess the progress of your condition and recommend the most appropriate treatment.

Our priority at Oculase will always be to deliver high-quality care that suits your needs and wishes. Contact us to learn how we can relieve you of your RCE symptoms.

 

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About the author

Mr Tariq Ayoub
Mr Tariq Ayoub, Consultant Ophthalmologist

Mr Ayoub has been rated as one of the top eye surgeons in the UK. He is a Consultant Ophthalmic Surgeon in London, based at Imperial College Healthcare NHS Trust, where he is also the Lead for the Emergency Department at Western Eye Hospital.

0330 128 1616

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