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.