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Epithelial Debridement

Corneal epithelial debridment with diamond burr polishing (abbreviated DBD) is a treatment for a hereditary irregularity of the skin (epithelium) of the cornea (the front part of the eye.)

Some people are born with loose “skin” of the cornea. The condition is called Anterior Basement Membrane Dystrophy (ABMD) or sometimes called Map-Dot-Fingerprint Dystrophy. In ABMD, the skin of the cornea is not firmly attached to the structural “middle” of the cornea. With the passage of the time on the body, this loose skin can start to break, causing pain in the eye when you awake from sleep. As we sleep, our eyes can become more dry, and the dry upper eyelid can rub against the loose skin and cause a scratch on the cornea. This condition can reoccur, and some people can have frequent pain or discomfort in the eye during the night on the morning due to recurrent breakdowns of the skin of the cornea.

Other people with ABMD can have irregularities of the skin of the cornea over the pupil “the black dot” in the eye, which can make your vision blurry, especially in the evening when the eye gets more dry.

Corneal epithelial debridment with Diamond Burr Polishing (DBD) is a treatment for this condition. DBD is performed in the office. The procedure takes about 5 minutes. Your eye is given drops to “numb” the eye so you will not feel any discomfort. Your eye will be held open with a special “eyelid holder” and the loose skin will be removed with a cotton swab. Then, the cornea is gently rubbed with a device to polish the undersurface (the diamond burr.) This takes less than 1 minute and does not hurt. The polishing of the cornea makes the new skin grow back firmly to the cornea, and greatly reduces the risk of the loose skin re-occurring. The polished literature states that this procedure has an 85% success rate, although we have found the success rate to be higher.

After the procedure, you will be given a special contact lens for the your eye which will stay in your eye until your next visit. The contact lens helps to reduce the discomfort. You will also be given eye drops to reduce the risk of infection and eye drops for pain.

The skin of the cornea will regrow completely in 36-72 hours, depending on the person, and the amount of skin removed. Your vision will be OK immediately after the procedure, but will get blurry after 1-2 days. The vision will slowly return to normal over the next 1-2 days. Some people state that it can take up to 6-8 weeks for the crispness of their vision to return, but this is not very common. Some people have severe pain after the procedure, but with the contact lens and the drop, this is also not very common.

Risks of the procedure include pain, infection, decreased vision, and a slight haze of the cornea. The benefits of the procedure include improved vision and a decrease or resolution of eye pain or discomfort.