Outcomes of epithelial debridement for anterior basement membrane dystrophy

To evaluate the outcomes of simple mechanical debridement for the management of anterior basement membrane dystrophy (ABMD) in a cohort of patients treated primarily for visual symptoms.

Retrospective, observational case series.

setting: Single center. study population: Seventy-four eyes of 55 patients treated with mechanical epithelial debridement over a 15-year period. observation procedures: We recorded symptoms, pre- and postoperative best-corrected visual acuity (BCVA), surgical technique, complications, and evidence of disease recurrence. main outcome measures: Mean best-corrected logMAR acuity and refractive errors, compared by using paired t tests or Wilcoxon signed-rank tests. Interval to recurrence of ABMD was determined by using Kaplan-Meier estimates.

Mean patient age was 74 years, and 80% were female. Visual difficulty was reported by the patient before the procedure in 61 eyes (82%), and erosion symptoms alone were noted before the procedure in the remaining 13 eyes. Mean BCVA improved from 20/44 before surgery to 20/30 (P = .0001) at the early follow-up visit and 20/33 (P = .0001) at the last follow-up (mean = 33 months). The mean refractive spherical equivalent changed -0.6 diopters (range, -4.75 to +2.0 diopters). No infections or persistent epithelial defects occurred. The most common postoperative complication was subepithelial haze, occurring in 19 eyes (26%). The five-year cumulative probability of recurrence of ABMD was 44.7%.

Our results with this simple technique are comparable to outcomes reported with other procedures used to treat ABMD. We recommend manual debridement as an effective option for ABMD affecting visual acuity.