Recurrent Corneal Erosion

Recurrent corneal erosion (RCE) is a rare complication of LASIK. This condition occurs when an area of the outer layer of the cornea (the epithelium) sloughs off.

Corneal erosions differ from corneal abrasions, which are usually caused by a mechanical rubbing or scraping of the eye. For example, if you have sand your eye and you rub your eyelid, the sand may scrape across your cornea, causing an abrasion. Corneal abrasions are somewhat common during LASIK eye surgery and are usually caused by the suction ring that attaches the microkeratome or femtosecond laser to the eye for creation of the corneal flap. An abrasion caused by the suction ring is usually superficial and heals without treatment within 24 to 48 hours.

Corneal erosions are more severe, affecting a larger area of the cornea than a typical corneal abrasion. However, in a small minority of LASIK patients, a small corneal abrasion from the suction ring may lead to a corneal erosion at the same location on the cornea.

A person's risk for corneal erosions increases with advancing age. People with a specific corneal dystrophy have a significantly higher risk of recurrent corneal erosions. Dry eye is also a risk factor.

Epithelial erosions cause significant discomfort, sensitivity to light, and blurred vision. Treatment usually consists of a bandage contact lens to improve comfort and facilitate healing, medicated eye drops to reduce the risk of infection, and frequent use of artificial tears while the epithelial cells grow back. In some cases, the surrounding epithelium is removed — either mechanically or with a laser — in hopes that the new epithelium that grows back will adhere better to the underlying cornea.