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Intervention Review

Interventions for recurrent corneal erosions

  1. Stephanie L Watson1,*,
  2. Nigel H Barker2

Editorial Group: Cochrane Eyes and Vision Group

Published Online: 17 OCT 2007

Assessed as up-to-date: 17 JUN 2007

DOI: 10.1002/14651858.CD001861.pub2


How to Cite

Watson SL, Barker NH. Interventions for recurrent corneal erosions. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD001861. DOI: 10.1002/14651858.CD001861.pub2.

Author Information

  1. 1

    Bondi Junction, NSW, Australia

  2. 2

    Morrings Eye Clinic, Bridgetown, Barbados

*Stephanie L Watson, Level 11/1 Newland Street, Bondi Junction, NSW, 2022, Australia. s.watson@unsw.edu.au.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 17 OCT 2007

SEARCH

This is not the most recent version of the article. View current version (12 SEP 2012)

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Recurrent corneal erosion is a common cause of disabling ocular symptoms and predisposes the cornea to infection. It may follow corneal trauma. Measures to prevent the development of recurrent corneal erosion following corneal trauma have not been firmly established. Once recurrent corneal erosion develops simple medical therapy (standard treatment) may lead to resolution of the episode. However some patients continue to suffer when such therapy fails and once resolved further episodes of recurrent erosion may occur. A number of treatment and prophylactic options are then available but there is no agreement as to the best option.

Objectives

To assess the effectiveness and safety of prophylactic and treatment regimens for recurrent corneal erosion.

Search methods

We searched CENTRAL, MEDLINE, EMBASE and LILACS in June 2007. The NRR was searched in April 2005. We also contacted researchers in the field.

Selection criteria

We included randomised and quasi-randomised trials that compared a prophylactic or treatment regimen with another prophylaxis/ treatment or no prophylaxis/ treatment for patients with recurrent corneal erosion.

Data collection and analysis

Both authors independently extracted data and assessed trial quality. We contacted study authors for additional information.

Main results

Five randomised and one quasi-randomised controlled trial were included in the review. The trials were heterogenous and of poor quality. Safety data presented were incomplete. For the treatment of recurrent corneal erosion there was limited evidence that oral tetracycline 250 mg twice daily for 12 weeks or topical prednisolone 0.5% four times daily for one week or both in addition to standard treatment; and excimer laser ablation in addition to mechanical debridement may be effective. Therapeutic contact lens wear was inferior to lubricant drops and ointment in abolishing the symptoms of recurrent corneal erosion and had a high complication rate. For prophylaxis of further episodes of recurrent corneal erosion there was no difference in the occurrence of objective signs of recurrent erosion between hypertonic saline ointment versus tetracycline ointment or lubricating ointment. Lubricating ointment at night in addition to standard treatment following traumatic corneal abrasion (erosion) caused by fingernail injury to prevent recurrence led to increased symptoms of recurrent corneal erosion compared to standard therapy alone.

Authors' conclusions

Well-designed masked randomised controlled trials using standardised methods are needed to establish the benefits of new and existing prophylactic and treatment regimes for recurrent corneal erosion.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Prophylactic and treatment regimens for recurrent corneal erosion

In recurrent corneal erosion repeated episodes of breakdown of the corneal surface produce disabling ocular symptoms and predispose the cornea to infection. Recurrent corneal erosion may follow corneal trauma. Prophylactic measures may be required to prevent the occurrence of recurrent erosion following trauma or to prevent further episodes of recurrent erosion once the diagnosis is made or both. Most episodes of recurrent corneal erosion resolve with simple medical therapy such as topical drops and ointment. Alternative treatment strategies are required when such simple measures fail. Randomised controlled trials of prophylactic and treatment regimens were of insufficient quality to provide evidence for the development of management guidelines. There was limited evidence that oral tetracycline or topical prednisolone or both, and excimer laser ablation may be effective treatments for recurrent corneal erosion. Further evidence is needed to guide the management of recurrent corneal erosion.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

角膜磨損的處置

經常發生的角膜磨損是導致眼睛受傷症狀的一個常見原因並且使角膜感染,它常伴隨角膜創傷。防止伴隨角膜創傷而發生的角膜磨損之預防措施尚未確立。經常出現的角膜磨損而發展的單純藥物治療(標準療法)可能解決事件的發生。當這樣的治療失敗,一些病患繼續受痛苦並且可能發生更進一步的反覆性磨損。許多處理和預防的措施被提供,但是關於最好處置,則沒有共識。

目標

對於反覆性的角膜磨損,評估其預防及治療藥物的效果及安全性。

搜尋策略

2007年6月,我們搜尋CENTRAL, MEDLINE, EMBASE and LILACS. 2005年4月搜尋NRR. 我們也聯繫在此領域的研究人員。

選擇標準

我們選擇隨機和類似隨機的控制試驗,比較各種處理和預防措施。

資料收集與分析

兩個作者獨立選出數據並且評估試驗品質。我們為附加訊息與研究作者聯繫。

主要結論

回顧文獻包括5篇隨機和1篇類似隨機控制試驗。試驗不具同質性且品質不佳。提出的安全數據不完全。處理反覆性角膜磨損的證據有限,每天兩次的口服tetracycline 250毫克持續12 周或者局部prednisolone 0.5%,一天4次持續一周或兩種藥物都加入標準處理方法;此外準分子鐳射部分消除術合併清創可能有效。在處理反覆性角膜磨損的效果,治療性隱形眼鏡不如潤滑劑和藥膏,並且有高併發症比率。對於更進一步的疾病預防措施與角膜磨損的症狀,高張性生理食鹽水藥膏與tetracycline 藥膏或潤滑藥膏比較,並無差別。與單獨的標準治療相比,指甲引起的創傷性角膜磨損在晚上潤滑藥膏合併標準治療,會導致症狀更反覆出現。

作者結論

為確立新的或既有藥物的治療效果來處理反覆性角膜磨損,標準化並設計良好的隨機控制盲性試驗是必要的。

翻譯人

本摘要由高雄榮民總醫院葉宣德翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

預防與處理反覆性角膜磨損。對於反覆性角膜磨損的患者,反覆的角膜表面受傷會造成眼部不適及角膜感染。角膜磨損常伴隨角膜創傷。一旦被診斷,預防措施可用來防止反覆性角膜磨損發生或進一步的惡化。反覆性角膜磨損大多用單純藥物治療即可,像眼藥水和眼藥膏。單純藥物治療無效,則需要其它處理方式。有關預防和處理的隨機控制試驗尚不足以提供治療的發展與證據。處理反覆性角膜磨損的證據有限:口服tetracycline,局部0.5%prednisolone藥膏,準分子雷射部分消除術可能有效。需要更進一步的證據來處理反覆性角膜磨損。