CORNEAL EPITHELIAL CHANGES IN EYES WITH POST TRAUMATIC RECURRENT CORNEAL EROSION: COMPARISON WITH FELLOW EYE AND HEALTHY CONTROLS

Trauma is a common cause of recurrent corneal erosion (RCE); however, only a few patients develop RCE after trauma. In this study, we describe corneal epithelial thickness changes in both affected and fellow eyes of patients with post-traumatic RCE and compare these with healthy age-matched controls.

This is a retrospective observational study conducted in a single tertiary care eye hospital.

 Patients presenting with traumatic recurrent corneal erosion (RCE) during a 3-year period were included. Corneal epithelial thickness data was obtained from high-resolution spectral domain OCT (Solix, Haag-Streit, Germany) corneal map scans at the follow-up visit in cornea clinic when the erosion had healed. Data was recorded for both affected (Group 1) and fellow eye (Group 2) and also for healthy age-matched controls (Group 3). comparison was made between the two and  Epithelial maps of healthy age matched controls were also obtained. Primary outcome measure was ‘E-Std Dev’ which indicates variation in epithelial thickness (ET). Secondary outcome measures were central ET, minimum ET and maximum ET.

30 patients (60 eyes) and 15 age matched healthy eyes were included. Those with pre-existing corneal dystrophies were excluded. E-Std Dev values were 4.53±2.01 µ, 2.83±1.19 µ and 1.75±0.49 µ in Groups 1, 2 and 3 respectively; the difference was statistically significant (P<0.01) and was maintained on post-hoc analysis between all three group pairs. Central ET, minimum ET and maximum ET were 56.63±7.36 µ, 55.23±9.42 µ and 65.43±1.17 µ respectively in Group 1; 49.33±6.44, 46.1 ±6.15 and 62.26±9.33 µ respectively in Group 2 and 54.8±9.86, 62.27± 9.97, 52.89 ±2.47 µ respectively in Group 3. There were no significant inter-group differences for central ET and minimum ET (P=0.07 & P=0.08); however, the difference was significant for maximum ET (P=0.03); post-hoc analysis for the latter revealed no difference between Groups 1 & 2 (P=0.27) but significant difference between Groups 1 & 3 (P=0.01) and Groups 2 & 3 (P=0.05).

We report corneal epithelial mapping changes for the first time in patients with traumatic recurrent corneal erosion. As can be expected, the maximum ET and variation in ET were highest in the affected eyes; however, even the fellow eyes showed significantly higher values as compared to healthy control eyes. This may suggest predisposition of some patients to develop RCE after trauma. Further prospective studies would be useful to shed more insight into this topic.