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In vivo confocal microscopy findings from full corneal epithelial debridement and local corticosteroid for recurrent corneal erosion

Eye (2026)Cite this article

Subjects

Abstract

Objectives

To evaluate the efficacy and safety of full corneal epithelial debridement (FCED) combined with local corticosteroids for recurrent corneal erosion (RCE), and to monitor corneal healing using in vivo confocal microscopy (IVCM).

Methods

This prospective study included 65 eyes from 65 patients with RCE who failed conventional treatments between May 2022 and July 2024. Data were collected via chart review and telephone surveys. Outcome measures included demographics, aetiology, symptom duration/recurrence, additional treatments, and complications. IVCM was performed pre-FCED and at 2 weeks, and 1, 3, and 6 months post-FCED.

Results

The study involved 28 males and 37 females with a mean age of 37.7 years. The primary cause was trauma (90.8%). Mean follow-up was 19.8 months. Mean best-corrected visual acuity (BCVA) improved from 0.29 pre-operatively to 0.11 post-operatively (p < 0.05). After 7 months, 71% of eyes showed complete resolution; after 1 year, the effective rate was 70%. Pain relief was reported in 97% of eyes after 3 days. Complications included elevated intraocular pressure in 2 patients and grade 2 haze in 1. Recurrence occurred in 29% of eyes, mostly within 3 months. IVCM revealed complete corneal epithelial repair by 2 weeks, but inflammatory cells persisted for up to 12 months, and sub-basal nerve regeneration was a lengthy process.

Conclusions

FCED with corticosteroids effectively alleviates symptoms and prevents recurrence in RCE. IVCM provides valuable insights into the healing process, confirming treatment efficacy. Adequate corticosteroid treatment is crucial to manage inflammatory responses and prevent recurrence.

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Fig. 1: Evolution of Slit Lamp Biomicroscopy and IVCM Images in a Patient With RCE After FCES Without Recurrence.
Fig. 2: Evolution of Slit Lamp Biomicroscopy and IVCM Images in a Patient with RCE Experiencing Recurrence After FCES.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

This study was funded by the Guangdong Medical Science and Technology Research Fund Project (No. B2023178); Shantou Science and Technology Program (No. 220507006492314).

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Authors and Affiliations

  1. Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China

    Honghe Xia, Zhiqiang Guan, Qi Zhang & Haoyu Chen

  2. GuangDong Engineering Technology Research Center of Precision Treatment for Ocular Diseases, Shantou, China

    Honghe Xia, Zhiqiang Guan, Qi Zhang & Haoyu Chen

  3. Guangdong Engineering Research Center of Intelligent Diagnosis and Treatment for Ocular Diseases, Shantou, 515041, China

    Honghe Xia, Zhiqiang Guan, Qi Zhang & Haoyu Chen

Authors
  1. Honghe Xia
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  2. Zhiqiang Guan
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Contributions

XHH: conceptualisation, methodology, data curation, data collection, writing first and final draft. GZQ: IVCM checking. ZQ: data collection. CHY: supervision and review. All authors approved the final manuscript and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Honghe Xia.

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Competing interests

Author Haoyu Chen is a member of the editorial board of Eye. All processes regarding the review and publication of this manuscript were conducted independently of this affiliation. The other authors declare no competing interests.

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Xia, H., Guan, Z., Zhang, Q. et al. In vivo confocal microscopy findings from full corneal epithelial debridement and local corticosteroid for recurrent corneal erosion. Eye (2026). https://doi.org/10.1038/s41433-026-04308-4

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