J Korean Ophthalmol Soc.  2013 Aug;54(8):1180-1186.

Phototherapeutic Keratectomy with or without Amniotic Membrane Transplantation for Symptomatic Bullous Keratopathy

• Lee HS
• Oh HJ
• Yoon KC

Abstract

PURPOSE
We evaluated the therapeutic effects of phototherapeutic keratectomy (PTK) with or without amniotic membrane transplantation (AMT) in patients who had symptomatic bullous keratopathy with poor visual potential.
METHODS
Twenty-five eyes of 25 patients with bullous keratopathy were reviewed retrospectively. Ten eyes (group A) were treated with PTK, and the other 15 eyes (group B) were treated with combined PTK and AMT. Changes of vision and symptoms, re-epithelization time, recurrence of bulla, central corneal thickness measured by anterior segment optical coherence tomography, and postoperative complications were analyzed.
RESULTS
At post-operative 3 months, visual acuity improved in 2 patients in both A and B groups. Nine patients in group A (90%) and 13 patients in group B (86.7%) showed symptom improvement. Mean re-epithelization time was 12.40 +/- 4.33 days in group A and 8.13 +/- 1.19 days in group B (p > 0.05). In both groups, central corneal thickness decreased postoperatively without statistically significant difference between groups. At the final follow-up visit, epithelial bulla had not recurred in 7 eyes (70.0%) in group A and 12 eyes (80.0%) in group B. No postoperative complication was detected.
CONCLUSIONS
PTK alone appears comparable to the combined treatment of PTK and AMT in terms of symptom improvement, re-epithelization time and recurrence rate.

Keyword

Amniotic membrane transplantation; Bullous keratopathy; Phototherapeutic keratectomy

MeSH Terms

Amnion
Blister
Eye
Follow-Up Studies
Humans
Postoperative Complications
Recurrence
Retrospective Studies
Tomography, Optical Coherence
Transplants
Vision, Ocular
Visual Acuity

Figure

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  Figure 1. A 50 year-old man with pseudophakic bullous keratopathy treated with phototherapeutic keratectomy. (A-C) Slit lamp photographs at preoperative period (A), postoperative 1 month (B) and 3 months (C). (D-F) Anterior segment optical coherence to-mography at preoperative period (D), postoperative 1 month (E), and 3 months (F).

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  Figure 2. A 44 year-old man with pseudophakic bullous keratopathy treated with phototherapeutic keratectomy and amniotic mem-brane transplantation. (A-C) Slit lamp photographs at preoperative period (A), postoperative 1 month (B) and 3 months (C). (D-F) Anterior segment optical coherence tomography at preoperative period (D), postoperative 1 month (E), and 3 months (F).

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