Should we patch corneal erosions?
J. D. Arbour, I. Brunette, H. M. Boisjoly, Z. H. Shi, J. Dumas and M. C. Guertin
Department of Ophthalmology, University of Montreal, Quebec.
OBJECTIVE: To study the effect of patching on the speed of
reepithelialization, slit-lamp signs of epithelial wound healing, and
patient discomfort following a corneal abrasion. METHODS: Forty-eight eyes
of 46 patients with corneal erosion sparing Bowman membrane were randomized
into 2 groups: with or without patching. Slit-lamp examination and
photographs of the fluorescein-stained cornea were performed on a daily
basis until reepithelialization was complete. Photographs were analyzed
using computer-assisted planimetry. RESULTS: No statistically significant
difference was found between patched (n = 25) and nonpatched (n = 22) eyes
for the mean size of the initial erosion (patched eyes, 23.7 mm2;
nonpatched eyes, 18.9 mm2; P = .42), linear speed of reepithelialization
(reduction over time of the radius of the largest circle included in the
erosion: patched eyes, 0.0375 mm/h; nonpatched eyes, 0.0353 mm/h; P = .78),
and surface speed of reepithelialization (reduction over time of the
erosion area: patched eyes, 0.6510 mm2/h; nonpatched eyes, 0.5657 mm2/h; P
= .60). The power to detect a 12-hour delay of epithelial closure was 95%.
There were no significant differences between the 2 groups for pain,
analgesia, insomnia, aspect of the epithelial border, intensity and
duration of stromal edema, Descemet folds, anterior uveitis, and filaments.
CONCLUSIONS: Patching a corneal erosion does not significantly accelerate
reepithelialization and does not alter the epithelial wound healing
pattern. It does not reduce the incidence and severity of inflammation nor
relieve pain when compared with treatment without patching.
