title: Amniotic membrane transplantation for bullous keratopathy in eyes with poor visual potential.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, USA.
authors.forename: Edgar M
authors.initials: EM
authors.lastname: Espana
authors.forename: Martin
authors.initials: M
authors.lastname: Grueterich
authors.forename: Helga
authors.initials: H
authors.lastname: Sandoval
authors.forename: Abraham
authors.initials: A
authors.lastname: Solomon
authors.forename: Eduardo
authors.initials: E
authors.lastname: Alfonso
authors.forename: Carol L
authors.initials: CL
authors.lastname: Karp
authors.forename: Francisco
authors.initials: F
authors.lastname: Fantes
authors.forename: Scheffer C G
authors.initials: SC
authors.lastname: Tseng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000650:Amnion / Q000637:transplantation*; D001684:Biological Dressings; D001768:Blister / Q000601:surgery*; D002675:Child, Preschool; D003316:Corneal Diseases / Q000601:surgery*; D003646:Debridement; D019573:Epithelium, Corneal / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity