Combined debridement and superficial keratectomy can be completed easily in the office setting, at the slit lamp, using topical proparacaine or a similar anesthetic drop. With sweeping and pushing motions using the trailing or leading edges of the instrument, keeping nearly parallel to the corneal plane, redundant basement membrane level material can be massaged away, while maintaining the integrity of Bowman layer. Following epithelial debridement, a 4 or 5 mm diameter diamond-dusted burr is very gently employed to polish the basement membrane throughout the area of epithelial debridement. Corneal anterior stromal needle puncture is useful for recurrent corneal erosions from trauma that recur in the same location. Lubricating, hypertonic saline or antibiotic ointment at bedtime is often helpful to prevent recurrent erosions.
Recurrent erosions predispose the cornea to infection.
The great majority of patients are able to maintain sufficient vision and comfort for reading, driving, and other visual tasks, except during episodes of corneal erosions. They may have an episode of pain and poor vision the day of their wedding or of an important presentation after being asymptomatic for weeks or months. Best seen with broad illumination beam. Cluster of corneal dots. Best seen in retroillumination.