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- W2036733685 abstract "Melacha1 has reported a case of recurrent corneal erosion following laser in situ keratomileusis (LASIK) that was successfully treated with anterior stromal puncture. The rationale for this approach was to enhance the adhesion between the basement membrane of the epithelium and the underlying stroma. Recent studies indicate that the pathogenetic mechanism of recurrent corneal erosion is related to enzymatic degradation of the epithelial basal membrane and corneal stroma.2,3 The cause of recurrent corneal epithelial erosion is believed to be a defect in epithelial anchoring due to a lack of hemidesmosomes. This leads to detachment of the epithelium and poor anchorage to the basement membrane and Bowman's layer.4 Current evidence suggests the abnormality in epithelial adhesion may be related to degradation of the epithelial attachment complexes by matrix-degrading enzymes.2,3 Increased levels of metalloproteinase 2 and 9 have been reported in the tear fluid of patients with recurrent erosions. The enzymes have the ability to dissolve the corneal epithelial basement membrane and anchoring fibrils. Based on the biochemical evidence implicating the increase in matrix metalloproteinase activity in the pathogenesis of this condition, inhibitors of metalloproteinase have been advocated to treat recurrent corneal erosions. Corticosteriods, oxytetracycline, and doxycycline are known to have inhibitory effects on metalloproteinase activity. Current reports indicate systemic tetracycline derivatives are effective in treating and reducing the frequency of recurrent corneal erosion.3 In our department, we have treated recurrent corneal erosion from a variety of underlying disorders with tetracycline derivatives. We recommend a trial of oxytetracycline or doxycycline be considered before surgical intervention. S. Ramamurthi MD K. Ramaesh MD Glasgow, United Kingdom" @default.
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- W2036733685 date "2005-01-01" @default.
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- W2036733685 title "Anterior stromal puncture for recurrent corneal erosion after laser in situ keratomileusis" @default.
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- W2036733685 doi "https://doi.org/10.1016/j.jcrs.2004.11.021" @default.
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