CORNEA EWAP SEPTEMBER 2022 49 symptoms after treatment, and 50% showed improvement but continued to have ocular irritation, suggestive of chronic ocular surface disease. So in total, more than 85% had some positive response to treatment. This is compelling data that suggests that the loose epithelium is responsible for the patients’ symptoms, he said. Among the people who had the occult corneal erosion that would have been missed, more than 38% of them only developed symptoms after cataract surgery. Additionally, more than half of those patients who had the occult corneal erosion came in to see Dr. Kim as a second opinion. “I think that as surgeons we need to acknowledge the fact that some at-risk patients can develop a recurrent corneal erosion after surgery. I want my colleagues to know about this so that they can be better equipped to handle these patients who are desperate for answers and seeking relief.” Dr. Kim stressed that while there is still research to be done, the technique is safe, and he has used it on hundreds of patients without complications. When thinking about when to incorporate the technique into practice, Dr. Kim suggested all it takes is a high index of suspicion. “Any patient with persistent ocular surface symptoms recalcitrant to standard treatment should undergo the corneal sweep test. “Another great aspect of the corneal sweep test is if you do it and it’s normal, you can tell the patient with confidence that they do not have a recurrent corneal erosion,” he said. “I think ruling out is just as important to be a successful diagnostician.” Currently, Dr. Kim’s approach is if a patient comes in with ocular surface symptoms, he will initiate standard therapies first. But if they fail those therapies, he proceeds straight to the corneal sweep test. He compared incorporating this instrument and technique into practice as similar to gonioscopy: It’s for select patients, it’s not invasive, it takes just a few minutes, it gives you immediate results, and there is no special training or learning curve. EWAP Reference 1. Kim ME, Kim DB. Implementation of the corneal sweep test in the diagnosis of recurrent corneal erosion: A 2-year retrospective study. Cornea. 2022. Online ahead of print. Editors’ note: Dr. Kim is in private practice with Professional Eye Associates, Dalton, Georgia, and has interests with Katena. The instrument is held shoYing the thin profile to enable a clear vieY of the corneal surface. 9hen the instrument encounters an area of loose epithelium a visible YrinMle or fold is induced highlighting the recurrent corneal erosion. Source (all): D. Brian Kim, MD ADVERTISER LISTING Alcon Page 5 www.alcon.com Johnson and Johnson Vision Page 2, 18-21 www.jjvision.com Oculus Page 9 www.cornealbiomechanics.com Zeiss Page 36-39 www.zeiss.com APACRS Page 6, 62, 63, 64 www.apacrs.org
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