CORNEA EWAP SEPTEMBER 2022 47 by Ellen Stodola Editorial Co-Director Corneal sweep test for recurrent corneal erosion Contact information Kim: kim@professionaleye.com New diagnostic techniques are often developed when a need in the clinic or OR arises. That is what led D. Brian Kim, MD, to develop the corneal sweep test and a new diagnostic tool to identify recurrent corneal erosion. Several years ago, Dr. Kim noticed that after draping the eye at the start of cataract surgery, some patients would have an area of loose corneal epithelium. Patients don’t feel it because the eye is numb, but it seemed strange because they never had corneal epithelial disease, he said. He also noticed that some patients after seemingly uneventful cataract surgery would develop a persistent ocular pain syndrome. These observations led Dr. Kim to use the back end of a corneal spud, often used to pull out foreign bodies stuck in the cornea, to sweep the corneal surface of these patients. He did this on the post- cataract surgery patients who were having persistent symptoms, foreign body sensation, burning, irritation, and sharp pain, after having tried and failed standard dry eye and blepharitis therapy. Dr. Kim called this method the “corneal sweep test,” adding that after finding these areas of loose epithelium, he would often treat by debriding with superficial keratectomy, and he discovered that it would improve the symptoms. One reason that Dr. Kim thinks the corneal sweep test is needed is because of the current way to diagnose recurrent corneal erosion. This is done using slit lamp biomicroscopy and vital stains such as yuorescein dye to inspect the surface of the cornea and to look for negative staining or irregularities on the cornea. “If there’s nothing there, we’re taught to say that there is no recurrent corneal erosion, and that’s the gap in our teaching,” he said. Dr. Kim realized that he would need to use a different instrument to test for these recurrent corneal erosions, especially if he wanted to encourage others to do the same. This led to the development of an instrument with Katena called the Kim Corneal Sweeper designed specifically for this purpose. Dr. Kim described the instrument as “an M&M candy on a stick.” It’s curved and smooth all around, but it has sidedness; one side is yatter. “You can sweep the cornea and because it’s rounded, it’s atraumatic, and because of the thin profile, you can see what’s happening as you’re indenting the cornea,” he said. Since adopting this technique in 2017, Dr. Kim has performed a retrospective chart review that has been published in the This article originally appeared in the June 2022 issue of EyeWorld. It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp. 4ound profile of the -im Corneal 5Yeeper. 4otated 9 degrees the 5Yeeper presents a flat profile. 0ote tapered edges for smooth design and thin profile enabling a clear vieY of the cornea during the sYeep maneuver.
RkJQdWJsaXNoZXIy Njk2NTg0