Amniotic membrane transplantation for symptomatic bullous keratopathy

Objective: To determine whether amniotic membrane transplantation can be us ed to treat symptomatic bullous keratopathy displaying poor visual potentia l. Methods: Amniotic membrane transplantation was performed at 5 centers on 50 consecutive eyes (50 patients) with symptomatic bullous keratopathy and po or visual potential. The underlying causes of bullous keratopathy included aphakia (9 eyes), pseudophakia (19 eyes), failed grafts (9 eyes), and other s (13 eyes). Results: During the follow-up period of 33.8 weeks (3-96 weeks) after amnio tic membrane transplantation, 43 (90%) of 48 eyes with intolerable pain pre operatively became pain free postoperatively. Among the 5 eyes with residua l pain, 3 received repeated amniotic membrane transplantation, 1 required a conjunctival flap for pain relief, and 1 had reduced pain. Epithelial defe cts 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. Conclusion: Amniotic membrane transplantation can be considered as an alter native to conjunctival flaps in alleviating pain, promoting epithelial heal ing, and preserving cosmetic appearance in patients with symptomatic bullou s keratopathy and poor visual potential.