Corneal debridement is a medical procedure that removes the cornea’s outermost layer, the epithelium, to clear away damaged or poorly attached cells. This allows a new, smoother, and healthier epithelial layer to grow. The process is like stripping old paint from a wall to ensure a new coat adheres properly, improving eye comfort and vision.
Medical Reasons for Corneal Debridement
A frequent reason for corneal debridement is Recurrent Corneal Erosion (RCE). In RCE, the epithelium does not stick securely to the underlying basement membrane. This weak attachment can cause the epithelium to rip away from minimal friction, like blinking or opening the eyes upon waking, which causes significant pain, light sensitivity, and a foreign body sensation.
Another indication is Epithelial Basement Membrane Dystrophy (EBMD), a genetic condition causing an abnormal basement membrane. This prevents the epithelium from forming a strong bond, leading to cellular buildup that creates ridges on the corneal surface. These ridges can destabilize the tear film, worsen dry eye, and cause blurry vision. Debridement also treats non-healing corneal defects or removes scar tissue, allowing healthy tissue to regrow.
The Procedure Step-by-Step
The procedure is performed in an ophthalmologist’s office and takes only a few minutes. First, anesthetic eye drops are applied to completely numb the eye’s surface, ensuring a painless process.
An eyelid speculum is used to hold the eyelids open. The ophthalmologist then uses a sterile instrument to wipe away the damaged epithelial cells. A polishing tool may be used to smooth the underlying layer, helping new cells adhere more firmly. The removal itself often takes less than a minute.
Recovery and Post-Procedure Care
Once the numbing drops wear off, typically within 20 to 40 minutes, discomfort and light sensitivity are common. The eye may burn, sting, and water as new epithelial cells grow. Patients should rest with their eyes closed as much as possible for the first couple of days.
A bandage contact lens is placed on the eye immediately after the procedure. This lens is not for vision correction but acts as a protective shield. It reduces pain by protecting the new tissue from the eyelid’s friction and creates a moist environment to aid healing. The lens remains in the eye until removed by the doctor at a follow-up appointment.
A regimen of medicated eye drops is prescribed to support healing and prevent complications. This includes an antibiotic drop to prevent infection and a steroid drop to manage inflammation. Following the prescribed schedule for these drops is important for a successful recovery.
The epithelial layer regrows quickly, covering the area within three to seven days. During this phase, vision will be blurry. After the bandage contact is removed, vision gradually improves over the following weeks, though it may take a few months to become fully crisp and stable.