关键词: 复发性角膜上皮糜烂, 激光治疗性角膜切削术

Abstract:  Objective To observe the clinical efficacy of laser therapeutic keratectomy combined with ocular surface intervention in recurrent corneal epithelial erosion (RCE). Design  Retrospective case series. Participants 52 cases (52 eyes) with RCE diagnosed in the Second People's Hospital of Foshan from November 2018 to June 2021. Methods RCE patients were divided into two groups based on their treatment methods. 26 patients (26 eyes) were treated with phototherapeutic keratectomy alone as group A, and 26 patients (26 eyes) were treated with phototherapeutic keratectomy combined with perioperative dry eye treatment as group B. All patients completed 1 year follow-up. Corneal repair refers to complete and transparent corneal epithelium checked and negative fluorescein staining by slit lamp examination. On the 7th day after surgery, the stimulation score was questionnaired, and 3 months later, the tear lipid, meibomian gland, BUT, and tear river height were examined with ocular surface comprehensive analyzer. Main Outcome Measures Eye stimulation response score, subjective stimulation symptom score, repair duration, eye surface condition, and postoperative complication rate. Results Eye stimulation response score was 5.38±1.30 in group A and 4.35±1.23 in group B and the subjective stimulation symptom score was 5.77±1.42 in group A and 4.5±1.45 in group B at 7th day after surgery. The repair duration of group A was 8.19±1.86 days, and that of group B was 6.19±1.23 days (P=0.001). At 3 months after surgery, the lipid score of group A was 2.23±0.59, and that of group B was 1.46±0.51. BUT of group A was 7.50±2.29 s, and that of group B was 10.66±2.28 s. The tear river height of group A was 0.30±0.09 mm and that of group B was 0.47±0.08 mm (all P<0.05). The meibomian gland loss score was 2.08±0.48 in group A and 1.85±0.46 in group B (P=0.08). The incidence of postoperative complications was 34.6 % in group A and 7.7 % in group B (P=0.038). Conclusions Phototherapeutic keratectomy combined with ocular surface intervention is effective in the treatment of recurrent corneal erosion, improving ocular surface status and reducing postoperative complications. (Ophthalmol CHN, 2023, 32: 339-343)

Key words:  recurrent corneal erosion, phototherapeutic keratectomy