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 p
atients were questioned about pain intensity, foreign-body sensation, and p
hotophobia. Biomicroscopy, esthesiometry, and pachymetry results were evalu
ated. The results before and after the punctures were compared using the Mc
Nemar test, Friedman test, and multiple comparison tests. Results. The comp
arisons among before and 1, 4, and 12 weeks after the anterior stromal punc
ture of pain (p = 0.00000556), photophobia (p = 0.0252), foreign-body sensa
tion (p = 0.0000743), and esthesiometry (p = 0.0243) showed significant sta
tistical differences in terms of decreasing symptoms and corneal sensitivit
y. 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. Conclusion.
Anterior stromal puncture is an effective, simple, and low-cost alternative
for treating patients with symptomatic bullous keratopathy.