{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:34:03Z","timestamp":1778596443548,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Epithelial basement membrane dystrophy (EBMD) is a common corneal dystrophy characterized by recurrent corneal erosions and visual impairments due to surface irregularities and opacities. This study aims to evaluate the effectiveness of alcohol-assisted delamination (ALD) of the corneal epithelium in patients with EBMD affecting the visual axis, who experience decreased vision quality due to higher-order aberrations (HOAs) and irregular astigmatism. Methods: Eleven eyes of nine patients (four males and five females) were treated with ALD, with a mean age of 51.3 \u00b1 19.7 years. All patients underwent refraction, best-corrected visual acuity (BCVA) assessment, a comprehensive slit-lamp examination for EBMD pattern identification, anterior segment imaging with and without fluorescein, tear break-up time (BUT) testing, corneal topography, corneal aberrometry (Zernike coefficients (Znm) were calculated for a 5.0 mm simulated pupil), and anterior segment optical coherence tomography preoperatively and at 1-day, 14-day, 1-month, 3-month, 6-month, and 12-month intervals. Results: All patients demonstrated improvements in BCVA and visual quality, ocular comfort, and BUT results. The mean root mean square (RMS) value of total corneal aberrations decreased from 1.72 \u00b1 0.90 \u03bcm to 0.90 \u00b1 0.62 \u03bcm, while the mean RMS value of HOAs reduced from 0.92 \u00b1 0.48 \u03bcm to 0.53 \u00b1 0.28 \u03bcm. Astigmatism and trefoil were the aberration components that exhibited the most significant reductions. Conclusions: Alcohol-assisted delamination of the corneal epithelium is a safe and effective treatment for central EBMD patients experiencing visual quality deterioration. Astigmatism and trefoil appear to be the primary aberrations contributing to visual disturbances in this patient population.<\/jats:p>","DOI":"10.3390\/jcm14072342","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T02:50:16Z","timestamp":1743389416000},"page":"2342","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Enhancing Visual Quality: The Impact of Alcohol-Assisted Delamination on Corneal Aberrations in Patients with Central Epithelial Basement Membrane Dystrophy"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1816-7322","authenticated-orcid":false,"given":"Marco","family":"Messina","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery, Ophthalmology Section, S. Maria della Misericordia Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2617-0289","authenticated-orcid":false,"given":"Giuseppe","family":"Giannaccare","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09127 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3812-9219","authenticated-orcid":false,"given":"Carlo","family":"Cagini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Ophthalmology Section, S. Maria della Misericordia Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8183-5365","authenticated-orcid":false,"given":"Paolo","family":"Fogagnolo","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Milan, 20146 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2403-9528","authenticated-orcid":false,"given":"Maria","family":"Poddi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Ophthalmology Section, S. Maria della Misericordia Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tommaso","family":"Bonifazi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Ophthalmology Section, S. Maria della Misericordia Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Mirabella","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Ophthalmology Section, S. Maria della Misericordia Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2410-6366","authenticated-orcid":false,"given":"Giulia","family":"Coco","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6535-9124","authenticated-orcid":false,"given":"Francesco","family":"Della Lena","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Ophthalmology Section, S. Maria della Misericordia Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/0039-6257(78)90090-5","article-title":"Corneal dystrophies. I. Dystrophies of the epithelium, Bowman\u2019s layer and stroma","volume":"23","author":"Waring","year":"1978","journal-title":"Surv. Ophthalmol."},{"key":"ref_2","first-page":"488","article-title":"Microcystic corneal dystrophy","volume":"74","author":"Laibson","year":"1976","journal-title":"Trans. Am. Ophthalmol. Soc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/ICU.0b013e32832c9716","article-title":"Review of diagnosis and management of recurrent erosion syndrome","volume":"20","author":"Ewald","year":"2009","journal-title":"Curr. Opin. 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