How do you approach the decision to escalate from conservative medical therapy to surgical intervention in a patient with EBMD-related recurrent corneal erosions who has not responded to several months of nighttime lubricating ointment?

In the case of recurrent erosion in the setting of EBMD, we first attempt to optimize the conditions for a pristine and smooth ocular surface. This includes non-preserved lubricants, hypertonic saline to avoid swelling and sloughing at night, and treatment of any dry eye and meibomian gland dysfunct...

For recurrent erosions with or without EBMD with two or more clear corneal erosion episodes a year, I usually recommend surgical interventions starting with SK and moving to PTK in case of recurrence. There are no studies recommending the number of erosions before going to surgery, but 2 seems a rea...