Long-term symptomatic relief of bullous keratopathy with amniotic membrane transplant

Int Ophthalmol. 2015 Dec;35(6):777-83. doi: 10.1007/s10792-015-0038-x. Epub 2015 Jan 14.

Abstract

The purpose of this study was to assess the long-term outcome of patients with symptomatic bullous keratopathy after amniotic membrane transplant. A retrospective cohort study includes that 20 patients with symptomatic bullous keratopathy, who have underwent amniotic membrane transplant at the Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Hospital, Hong Kong between 04/1998 and 06/2011, were invited back. Clinical examination was performed, including, pain score assessment (pain score out of 10), epithelial healing, and vision. A total of 21 eyes of 20 patients returned for our study. The majority of eyes experienced pain reduction (94 %), with a significant mean pain score difference of 6.8 ± 2.6, 2-tail p < 0.001 (99 % CI 4.9-8.7). The mean pre-operative and post-operative pain scores were 7.3 ± 2.9 and 0.5 ± 1.0, respectively. 16 eyes (76 %) were completely pain free, and 10 eyes (47 %) remained symptom free after a mean follow-up of 39.0 ± 36.3 months (range 5-171 months). The median epithelial healing time was 2 weeks (range 1-20 weeks). Amniotic membrane transplant may be considered as a longer-term treatment for bullous keratopathy patients, especially in patients with poorer visual prognosis, but it may also be used as an interim measure for patients awaiting corneal transplant.

Keywords: Amniotic membrane; Bullous keratopathy; Cornea; Keratoplasty; Transplantation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amnion / transplantation*
  • Blister / surgery
  • Corneal Diseases / physiopathology
  • Corneal Diseases / surgery*
  • Epithelium, Corneal / pathology
  • Female
  • Hong Kong
  • Humans
  • Keratoplasty, Penetrating / methods*
  • Male
  • Middle Aged
  • Pain, Postoperative
  • Retrospective Studies
  • Visual Acuity / physiology