Amniotic membrane transplantation for symptomatic bullous keratopathy.
OBJECTIVE
To determine whether amniotic membrane transplantation can be used to treat symptomatic bullous keratopathy displaying poor visual potential.


METHODS
Amniotic membrane transplantation was performed at 5 centers on 50 consecutive eyes (50 patients) with symptomatic bullous keratopathy and poor visual potential. The underlying causes of bullous keratopathy included aphakia (9 eyes), pseudophakia (19 eyes), failed grafts (9 eyes), and others (13 eyes).


RESULTS
During the follow-up period of 33.8 weeks (3-96 weeks) after amniotic membrane transplantation, 43 (90%) of 48 eyes with intolerable pain preoperatively became pain free postoperatively. Among the 5 eyes with residual pain, 3 received repeated amniotic membrane transplantation, 1 required a conjunctival flap for pain relief, and 1 had reduced pain. Epithelial defects in 45 (90%) of 50 eyes created and covered by amniotic membrane healed rapidly within 3 weeks. Only 4 eyes (8%) showed recurrent surface breakdown. Epithelial edema or bullae recurred in a smaller area in 5 eyes (10%) and pseudopterygium developed in 1 eye.


CONCLUSIONS
Amniotic membrane transplantation can be considered as an alternative to conjunctival flaps in alleviating pain, promoting epithelial healing, and preserving cosmetic appearance in patients with symptomatic bullous keratopathy and poor visual potential.
Pires
R T
RT
Ocular Surface and Tear Center, Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL 33136, USA.
Tseng
S C
SC
Prabhasawat
P
P
Puangsricharern
V
V
Maskin
S L
SL
Kim
J C
JC
Tan
D T
DT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000650:Amnion / Q000637:transplantation*; D001768:Blister / Q000601:surgery*; D003316:Corneal Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010166:Palliative Care; D012086:Reoperation; D014792:Visual Acuity; D014945:Wound Healing