A Cochrane review included 8 studies with a total of 443 subjects. Safety data presented were incomplete. For the treatment of recurrent corneal erosion, one study (n=30) showed that oral tetracycline 250 mg twice daily for 12 weeks or topical prednisolone 0.5% four times daily for one week or both in addition to standard treatment accelerated healing rates and improved symptoms. Excimer laser ablation in addition to mechanical debridement may reduce the number of erosions and improve symptoms (1 study, n=56). Transepithelial technique for excimer laser ablation had the same efficacy as the traditional subepithelial excimer laser technique but caused less pain (1 study, n=100). In a small study (n=24) therapeutic contact lens wear was inferior to lubricant drops and ointment in abolishing the symptoms of recurrent corneal erosion and had a high complication rate, although the contact lenses used were the older generation with low oxygen permeability. A recent study (n=48) found diamond burr polishing to reduce episodes of recurrent corneal erosion.
For prophylaxis of further episodes of recurrent corneal erosion there was no difference in the occurrence of objective signs of recurrent erosion between hypertonic saline ointment versus tetracycline ointment or lubricating ointment (1 study, n=26). Also, there was no difference in symptom improvement between hypertonic saline versus paraffin ointment when used for prophylaxis (1 study, n=117). Lubricating ointment at night in addition to standard treatment following traumatic corneal abrasion (erosion) caused by fingernail injury to prevent recurrence led to increased symptoms of recurrent corneal erosion compared to standard therapy alone (1 study, n=42).
Comment: The quality of evidence is downgraded by study limitations (inadequate or unclear allocation concealment), by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (limited study size for each comparison).