title: Anterior stromal puncture in the treatment of bullous keratopathy: six-month follow-up.
abstract: OBJECTIVE
  This study was designed to evaluate the effect of anterior stromal puncture to treat patients with symptomatic bullous keratopathy.
  
  
  METHODS
  Fourteen patients with bullous keratopathy who had decreased vision and were or were not awaiting penetrating keratoplasty were evaluated before and 1, 4, 12, and 24 weeks after anterior stromal punctures with a 25-gauge needle. The patients were questioned about pain intensity, foreign-body sensation, and photophobia. Biomicroscopy, esthesiometry, and pachymetry results were evaluated. The results before and after the punctures were compared using the McNemar test, Friedman test, and multiple comparison tests.
  
  
  RESULTS
  The comparisons among before and 1, 4, and 12 weeks after the anterior stromal puncture of pain (p = 0.00000556), photophobia (p = 0.0252), foreign-body sensation (p = 0.0000743), and esthesiometry (p = 0.0243) showed significant statistical differences in terms of decreasing symptoms and corneal sensitivity. The average pachymetry did not show statistical difference among before and 1, 4, 12, and 24 weeks after the procedure (p = 0.956). We did not find important differences in terms of corneal neovascularization.
  
  
  CONCLUSIONS
  Anterior stromal puncture is an effective, simple, and low-cost alternative for treating patients with symptomatic bullous keratopathy.
authors.affiliation: External Disease and Cornea Service, Department of Ophthalmology, Federal University of São Paulo (UNIFESP), Brazil.
authors.forename: J A
authors.initials: JA
authors.lastname: Gomes
authors.forename: D K
authors.initials: DK
authors.lastname: Haraguchi
authors.forename: D U
authors.initials: DU
authors.lastname: Zambrano
authors.forename: L
authors.initials: L
authors.lastname: Izquierdo Júnior
authors.forename: M C
authors.initials: MC
authors.lastname: Cunha
authors.forename: D
authors.initials: D
authors.lastname: de Freitas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery*; D003319:Corneal Stroma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011677:Punctures; D016896:Treatment Outcome; D014792:Visual Acuity