[Recurrent corneal erosion: modern view of the problem]

Area of Science:

• Ophthalmology
• Corneal Diseases
• Epithelial Biology

Background:

• Recurrent corneal erosion syndrome (RCES) is a chronic condition characterized by repeated epithelial disruptions.
• It stems from impaired epithelial adhesion to the corneal stroma, linked to abnormal basement membrane regeneration.
• Inflammatory mediators and proteinases exacerbate adhesion complex destruction.

Purpose of the Study:

• To outline the diagnosis and management strategies for Recurrent Corneal Erosion Syndrome.
• To differentiate RCES from infectious corneal lesions requiring different treatments.

Main Methods:

• Diagnosis relies on characteristic medical history and biomicroscopy.
• Examination may reveal epithelial defects, loose epithelium, microcysts, or fingerprint patterns.
• Differential diagnosis must exclude infectious keratitis.

Main Results:

• First-line treatment includes lubricants, epithelialization promoters, and inhibitors of matrix metalloproteinases and lipases.
• Second-line conservative treatment may involve blood derivatives.
• Surgical options like phototherapeutic keratectomy (PTK) or diamond burr polishing are considered if conservative therapy fails.

Conclusions:

• Treatment choice for RCES depends on therapeutic effectiveness, recurrence frequency, disease duration, symptom severity, and available surgical expertise.
• A stepwise approach, starting with conservative measures and progressing to surgical interventions, is recommended.