ESCRS - POCOR524 - Long-Term Outcomes Of Alcohol Delamination For Recurrent Corneal Erosion Syndrome: A 13-Year Retrospective Case Series

Long-Term Outcomes Of Alcohol Delamination For Recurrent Corneal Erosion Syndrome: A 13-Year Retrospective Case Series

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR524 | Type: Free paper | DOI: 10.82333/9ts1-b495

Authors: Dr Vignesh Paulpandian* 1 , Mr Chrishan Gunasekera 2

1Ophthalmology,Norfolk and Norwich University Hospital NHS Foundation Trust,Norwich,United Kingdom, 2Ophthalmology,Norfolk and Norwich University Hospital NHS Foundation Trust,Norwich,United Kingdom;Ophthalmology,James Paget University Hospital NHS Foundation Trust,Great Yarmouth,United Kingdom

Purpose

To evaluate the long-term safety and efficacy of alcohol delamination of the corneal epithelium in the management of recurrent corneal erosion syndrome (RCES).

Setting

Norfolk and Norwich University Hospital NHS Foundation Trust, United Kingdom.

Methods

This retrospective consecutive case series included patients undergoing alcohol delamination between 2014 and 2025 for symptomatic RCES. The surgical technique involved application of 20% ethanol to loosen the corneal epithelium, followed by epithelial removal and standard postoperative ocular surface rehabilitation.
The primary outcome was recurrence, defined as return of symptomatic epithelial instability. Partial recurrence was defined as recurrence managed medically; total recurrence required further procedural intervention. Secondary outcomes included change in corrected distance visual acuity (CDVA), epithelial healing time, and complications.

Results

A total of 182 procedures were performed in 165 patients (17 bilateral). Mean age was 56.2 ± 9.2 years, with a male:female ratio of 1:1.5. Indications were recurrent erosions (n=89), visual disturbance (n=42), or both (n=51). Mean follow-up was 21 months (range 6–37). Recurrence occurred in 16 cases (8.8%) at a mean of 10 months. Four partial recurrences were managed medically, 12 total recurrences required further intervention (repeat alcohol delamination n=3; PTK n=9). Mean CDVA improved by 0.3 logMAR. Mean epithelial healing time was 32.5 ± 7.2 days. Complications were rare: one infectious keratitis resolved medically and one delayed epithelial healing resulted in corneal scarring. Postoperative haze was noted in six recurrence cases.

Conclusions

Alcohol delamination using 20% ethanol is a safe and effective treatment for RCES, demonstrating durable symptom control with a low recurrence rate (<10%) over extended follow-up. The procedure provides meaningful visual improvement with a low complication profile and remains a valuable first-line surgical option prior to excimer laser intervention.