Implementation of the Corneal Sweep Test in the Diagnosis of Recurrent Corneal Erosion: A 2-Year Retrospective Study.

PURPOSE: The purpose of this study was to evaluate the incidence and epidemiology of recurrent corneal erosion within a clinical population using standard diagnostic techniques and a new technique called the corneal sweep test (CST). METHODS: A retrospective chart review was conducted on 58 eyes of 51 patients with the diagnosis of recurrent corneal erosion from July 2018 to June 2020. All underwent a thorough history and physical examination. The CST was performed as a confirmatory test and on any patient who lacked visible corneal pathology. RESULTS: The CST was necessary on 49 of the 58 eyes to help confirm the diagnosis of a corneal erosion. Among them, 34 had an occult corneal erosion, which is defined as having a normal-appearing cornea on slitlamp examination but found to have loose corneal epithelium with the CST. Clear corneal cataract surgery (28 eyes, 48.2%) was the most common presumed mechanism of injury, with 20 (71.4%) developing symptoms only after cataract surgery. All 20 eyes had an erosion located directly over a clear corneal cataract incision. CONCLUSIONS: The CST is a new and effective technique to help diagnose corneal erosions in the absence of visible corneal findings. Clear corneal cataract surgery is an under-recognized but important risk factor to consider because the incision can be the source for an erosion. Using the CST could lead to a paradigm shift in the way clinicians approach RCEs and patients with a persistent ocular pain syndrome.

Cataract incision-related corneal erosion: recurrent corneal erosion because of clear corneal cataract surgery.

Three patients developed recurrent corneal erosions (RCEs) over their cataract surgery corneal incisions. These cataract incision-related corneal erosions (CIRCEs) resulted in pain after cataract surgery. None had any physical findings for corneal erosion; thus, a new technique called the corneal sweep test was developed to identify the erosion. To the authors' knowledge, this is the first time this association between the clear corneal cataract incision and RCEs has been reported. Considering the high number of cataract surgeries performed around the world, it is important for ophthalmologists to recognize CIRCEs as a potential cause of ocular discomfort after clear corneal cataract surgery.