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Clin Ophthalmol 2019 11;13:325-335. Epub 2019 Feb 11.

Department of Ophthalmology, Mayo Clinic, Jacksonville, FL 32224, USA,

Purpose: To comprehensively review the literature regarding recurrent corneal erosion (RCE) and to present treatment options and recommendations for management.

Overview: RCE usually presents with sharp, unilateral pain upon awakening, in an eye with an underlying basement membrane dystrophy, prior ocular trauma, stromal dystrophy or degeneration, or prior surgery for refractive errors, cataracts, or corneal transplantation. Making the correct diagnosis requires a careful slit-lamp examination of both eyes coupled with a high degree of suspicion. Read More

Am J Ophthalmol Case Rep 2018 Dec 8;12:101-102. Epub 2018 Nov 8.

Department of Ophthalmology, The Permanente Medical Group, 3772 Howe Street, Oakland, CA, USA.

Graefes Arch Clin Exp Ophthalmol 2015 Oct 22;253(10):1745-9. Epub 2015 Apr 22.

Medignition Inc, Research Consultants, Zurich, Switzerland.

Background: To evaluate and compare the efficacy of phototherapeutic keratectomy (PTK) for recurrent corneal erosion (RCE) caused by trauma, map-dot-fingerprint dystrophy (MDF) or instances without an established cause.

Methods: Single center prospective longitudinal study. Between January 2003 and November 2006 we treated 89 eyes of 82 patients with PTK. Read More

Clin Ophthalmol 2012 27;6:1187-90. Epub 2012 Jul 27.

Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

Background: The purpose of this study was to investigate pathological changes of the corneal cell layer in patients with map-dot-fingerprint (epithelial basement membrane) dystrophy by in vivo laser corneal confocal microscopy.

Methods: Two patients were evaluated using a cornea-specific in vivo laser scanning confocal microscope (Heidelberg Retina Tomograph 2 Rostock Cornea Module, HRT 2-RCM). The affected corneal areas of both patients were examined. Read More

Dev Ophthalmol 2011 26;48:116-53. Epub 2011 Apr 26.

Department of Ophthalmology, University of Saarland, Homburg/Saar, Germany.

Corneal dystrophies typically result in a gradual bilateral loss of vision in a primary 'white eye' - often in conjunction with epithelial defects in later stages. Treatment of corneal dystrophies needs to be stage-related. To ensure a stage-related therapeutic approach, an adequate classification based on clinical, histopathological and genetic knowledge is indispensable. Read More

Mol Vis 2010 Jul 29;16:1429-38. Epub 2010 Jul 29.

Laboratory of Cyto-Molecular Genetics, Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India.

Purpose: To screen a cohort of corneal dystrophy patients from North India for mutations in the transforming growth factor beta induced (TGFBI) gene, to correlate genotypes to phenotypes, to describe structural implications of various mutations on protein function, and to discuss the implications for diagnosis.

Methods: Eighty affected individuals from 61 unrelated families, who were diagnosed with autosomal dominant granular and/or lattice corneal dystrophy, were recruited for the study. Detailed clinical evaluation was undertaken for these patients to establish their corneal phenotypes. Read More

Br J Ophthalmol 2010 Jul;94(7):933-9

Department of Ophthalmology, University of Florence, Italy.

Aim: To investigate by electron microscopy the plane of separation of the epithelial sheet from its substratum in the procedure of alcohol delamination (ALD) in patients with recurrent corneal erosion syndrome.

Methods: Ten cases of recurrent corneal erosions (RCE) secondary to trauma and seven cases related to map-dot-fingerprint dystrophy (MDFP) were treated with ALD. The epithelial sheets obtained from these patients were examined by transmission electron microscopy. Read More

Invest Ophthalmol Vis Sci 2009 Sep 30;50(9):4192-8. Epub 2009 Apr 30.

Department of Ophthalmology, Linköping University Hospital, Linköping, Sweden.

Purpose: To examine the role of Bowman's layer (BL) on the nature of anterior corneal regeneration after excimer laser phototherapeutic keratectomy (PTK).

Methods: A cohort of 13 patients underwent PTK to remove either 7 mum of BL for treatment of primary recurrent corneal erosions (RCE; six patients) or complete BL removal (15-mum ablation) to treat RCE or poor vision secondary to map-dot-fingerprint (MDF) dystrophy (seven patients). Clinical examinations and laser-scanning in vivo confocal microscopy (IVCM) were conducted before surgery and at a mean of 4 and 8 months after surgery. Read More

Arq Bras Oftalmol 2008 May-Jun;71(3):415-8

Division of Cornea, External Disease and Refractive Surgery, W. K. Kellogg Eye Center, University of Michigan Medical School, Michigan, USA.

Purpose: To evaluate the efficacy and safety of diamond burr superficial keratectomy in the treatment of visually-significant anterior corneal lesions.

Methods: A retrospective review of 23 eyes (23 patients). Pre- and postoperative visual acuities and refractions, slit-lamp biomicroscopic findings, and the incidence of recurrence of disease after keratectomy were studied. Read More

Cornea 2006 Aug;25(7):774-7

Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany.

Purpose: Patients with corneal map-dot-fingerprint dystrophy suffer typically from recurrent corneal erosion, disturbed vision, or both. The purpose of this study was to assess the morphologic and functional long-term results of minimal invasive subepithelial phototherapeutic keratectomy (PTK) for corneal map-dot-fingerprint dystrophy.

Methods: Of a total of 390 PTKs performed between October 1994 and January 2004, 15 PTKs on 15 eyes of 11 patients were included in this single-center study. Read More

J Cataract Refract Surg 2006 Jun;32(6):958-61

New York Medical College, Westchester Medical Center, Department of Ophthalmology, Valhalla, New York, USA.

Purpose: To investigate the changes in symptoms, refraction, and visual acuity (VA) in patients with corneal surface disease and refractive errors who had phototherapeutic keratectomy (PTK) combined with photorefractive keratectomy (PRK).

Setting: University-based referral practice.

Methods: Patients with myopia or astigmatism and map-dot-fingerprint dystrophy or recurrent erosions were treated. Read More

Hum Mutat 2006 Jun;27(6):553-7

Centre de Recherche Thérapeutique en Ophtalmologie (CERTO), Faculté Necker-Enfants Malades, Paris, France.

Epithelial basement membrane corneal dystrophy (EBMD), also known as Cogan microcystic epithelial dystrophy or map-dot-fingerprint dystrophy, is a common bilateral epithelial dystrophy. Usually, this disease is not considered to be inherited although several families with autosomal dominant inheritance have been described. We report the analysis of two families with an autosomal dominant pattern of inheritance as well as the analysis of single affected individuals; we identified two different point mutations in the TGFBI/BIGH3 genes, genes known to be associated with other corneal dystrophies. Read More

J Cataract Refract Surg 2005 Nov;31(11):2133-6

Department of Ophthalmology, Tuen Mun Hospital, Hospital Authority Ophthalmic Services, Hong Kong Special Administrative Region, China.

Purpose: To evaluate the long-term efficacy and safety of shallow ablations in phototherapeutic keratectomy (PTK) in patients with recurrent corneal erosions.

Setting: Department of Ophthalmology, Tuen Mun Hospital, Hong Kong, China.

Methods: A retrospective analysis of 13 consecutive eyes with recurrent corneal erosions treated by PTK from 1997 to 1999 was performed. Read More

Acta Ophthalmol Scand 2003 Feb;81(1):19-32

Department of Ophthalmology, University Hospital, SE-581 85 Linköping, Sweden.

Background: Phototherapeutic keratectomy (PTK) has been employed as a surgical tool to treat corneal disease for more than 10 years. The laser has made it possible to remove superficial corneal opacities and thereby restore vision. The 193 nm ultraviolet light separates molecules and splits molecules in biological tissue, thereby ablating it. Read More

J Fr Ophtalmol 2002 Jun;25(6):594-8

Service d'Ophtalmologie, Hôpital Hôtel-Dieu, 1 place du Parvis Notre Dame, 75181 Paris Cedex 04, France.

Purpose: This retrospective study was designed to investigate the therapeutic potential of phototherapeutic keratectomy (PTK) for the treatment of map-dot-fingerprint corneal dystrophy (MDFCD).

Patients And Methods: PTK was performed with the Excimed UV 200 and with the Nidek EC5000 on 38 patients (55 eyes). Mean patient age was 51 years (range, 28-86 years). Read More

Oftalmologia 2001 ;54(4):13-4

Clinica Oftalmologică Cluj-Napoca.

The review presents a clinical case of 40 years old female patient with bilateral recurrent corneal erosions (r.c.e. Read More

Arch Soc Esp Oftalmol 2002 May;77(5):257-62

Hospital General Yagüe (Burgos), Instituto de Oftalmobiología Aplicada (Valladolid), España.

Purpose: Assess the efficacy of corneal anterior stromal punctures as treatment for Recurrent Corneal Erosion (RCE) and relapse prevention. Two other treatments are compared: simple occlusion with antibiotic ointment, not manipulating the lesion and debridement of erosion previous to occlusion.

Material And Method: A retrospective study was performed on a total of 36 patients diagnosed with RCE where cases underwent different treatments and results were compared. Read More

Br J Ophthalmol 2002 Mar;86(3):296-8

WK Kellogg Eye Center, University of Michigan Medical School, Ann Arbor 48105, USA.

Aims: To evaluate the efficacy and safety of diamond burr superficial keratectomy in the treatment of recurrent corneal erosions.

Methods: A retrospective review of 54 eyes (47 patients) with recurrent corneal erosions treated with diamond burr superficial keratectomy. Preoperative and postoperative visual acuities and refractions, slit lamp examination findings, and the incidence of recurrent erosion after keratectomy were studied. Read More

Cornea 2001 Apr;20(3):309-16

Department of Surgery, Burns & Allen Research Institute, Cedars-Sinai Medical Center, University of California at Los Angeles Medical School Affiliate, 90048, USA.

Purpose: Activated myofibroblasts and macrophages are often found in corneal wound models. The current study was performed to determine whether human diseased corneas that had active tissue remodeling and enzyme activities also possessed myofibroblasts, macrophages, major histocompatibility complex class II cells, and/or CD-68-positive cells.

Methods: Normal, keratoconus, keratoconus with hydrops, bullous keratopathy, map-dot-fingerprint dystrophy, failed grafts, and acid burn/neovascularized corneas were collected, frozen in OCT, sectioned, and stained with antibodies to alpha smooth muscle actin (myofibroblast marker), CD14 (macrophage marker), CD68 (lysosomal membrane marker), and HLA-DR (major histocompatibility complex class II cells). Read More

Cornea 1998 Nov;17(6):595-9

St. Erik Eye Hospital, Stockholm, Sweden.

Purpose: To evaluate the excimer laser as a surgical instrument to treat map-dot-fingerprint (MDF) dystrophies.

Methods: Thirty eyes (24 patients) with MDF dystrophy were treated with phototherapeutic keratectomy (PTK). The treatment goal was either to improve vision (24 eyes) or to heal recurrent corneal erosions or both (10 eyes). Read More

J Refract Surg 1998 Mar-Apr;14(2):129-35

St. Erik Eye Hospital and Karolinska Institutet, Stockholm, Sweden.

Purpose: To evaluate the excimer laser as a surgical instrument for treatment of corneal dystrophies.

Methods: Excimer laser photoablation was performed with the Summit UV 200 and VISX 20/20 excimer lasers on 30 eyes of 21 patients with different types of corneal dystrophies; phototherapeutic keratectomy (PTK) on 28 eyes (20 patients) and photorefractive keratectomy (PRK) on two eyes (one patient). The treatment goals were to improve visual acuity (26 eyes of 18 patients), heal recurrent corneal erosions (eight eyes of five patients), and treat fluctuating refraction and visual acuity (three eyes of two patients). Read More

Ann Ophthalmol 1993 Jan;25(1):35-6

Department of Ophthalmology, Kentucky Lions Eye Research Institute, University of Louisville, Birmingham.

Br J Ophthalmol 1985 Jun;69(6):435-7

A series of recurrent corneal erosions secondary to map-dot-fingerprint dystrophy is presented. Erosions were closely related to the Hudson-Stahli line, and this may be a factor in pathogenesis. Traumatic abrasions did not demonstrate such localisation, evidence that trauma is not a primary cause. Read More

Can J Ophthalmol 1984 Oct;19(6):266-8

Irregular astigmatism, the clinical manifestation of corneal warpage, was evaluated as a cause of decreased visual acuity in 24 patients with anterior membrane dystrophy (map-dot-fingerprint type). Qualitative ophthalmometry demonstrated corneal warpage in 20 of the patients. The best corrected visual acuity was improved with contact lenses over that achieved with spectacles in 14 of the 20. Read More

Ann Ophthalmol 1984 Jun;16(6):567, 570-1

A scalloped line of tear film thinning (corneal valance), running horizontally across the top third of the cornea, was readily seen with slit lamp, fluorescein, and blue filter in 25 patients. Careful retrospective examination of these patients revealed barely discernible map and fingerprint lines corresponding to the areas of tear film irregularity. A corneascope photograph suggests that the tear film thinning in corneal valance is caused by localized elevations of the epithelial surface. Read More

Ophthalmic Surg 1982 Jan;13(1):27-35

We have observed the following complications with radial keratotomy which require further evaluation: missing the visual axis while marking the central cornea, regression of myopic flattening, epithelial defects, recurrent erosions, stromal overgrowth, Cogan's map-dot fingerprint corneal dystrophy with Moncreiff iron lines, blood in the incisions, vascular ingrowth, perforation of the anterior chamber, induction of astigmatic errors, epithelial ingrowth, glare complaints and decreased night vision, pain, fluctuating vision from morning to evening, overcorrection and unpredictable results, contact lens refitting difficulties, endothelial cell loss, and corneal scarring. We feel these complications require extensive further study before the relative safety and long-term efficacy of this experimental procedure may be determined. Read More

Ann Ophthalmol 1979 Mar;11(3):341-6

A 31-year-old woman with subepithelial corneal opacification and numerous clear round or oval areas of epithelial edema confined to the palpebral fissure underwent a penetrating keratoplasty. The clinical appearance was similar to that of a severe Meesmann or Stocker-Holt dystrophy. The prominent histopathologic features were thickening and excrescences of the epithelial basement membrane, intense basal cell edema, but no intraepithelial cysts. Read More