Amniotic membrane transplantation for bullous keratopathy in eyes with poor visual potential

Edgar M. Espana, Martin Grueterich, Helga Sandoval, Abraham Solomon, Eduardo Alfonso, Carol L. Karp, Francisco Fantes, Scheffer C.G. Tseng

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Purpose: To evaluate the long-term outcomes of epithelial debridement and amniotic membrane transplantation (AMT) for pain and discomfort relief in patients with symptomatic bullous keratopathy and poor visual potential. Setting: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA. Methods: This retrospective study included 18 eyes (18 patients) with bullous keratopathy presenting with intractable pain or discomfort and poor visual potential. After epithelial debridement, all eyes had AMT with the basement membrane side up. During a mean follow-up of 25.1 months ± 9.6 (SD) (range 12 to 45 months), pain relief, epithelial healing, and visual changes were analyzed. Results: Pain relief was obtained in 88% of patients. Sixty-six percent of eyes had complete resolution of ocular discomfort starting soon after the first postoperative day. One eye had evisceration for persistent pain 10 months postoperatively. Corneal epithelial healing was complete in all except 1 eye. Remaining complaints included foreign-body sensation (5%), tearing (11%), and photophobia (5%). Conclusions: Amniotic membrane transplantation was a safe, effective, and long-lasting treatment modality for intractable pain associated with chronic bullous keratopathy in eyes with poor visual potential. It can be an alternative to conjunctival flaps for the long-term management of patients with bullous keratopathy in whom corneal transplantation is not indicated. A comparison of the efficacy of AMT with that of other surgical procedures must be performed.

Original languageEnglish (US)
Pages (from-to)279-284
Number of pages6
JournalJournal of cataract and refractive surgery
Volume29
Issue number2
DOIs
StatePublished - Feb 1 2003

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology
  • Sensory Systems

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