Superficial epithelial keratectomy, cautery, and amniotic membrane transplant for the treatment of painful bullous keratopathy in eyes with poor visual potential.

Abstract

The aim of this study was to report a new technique for the treatment of painful bullous keratopathy in eyes with poor visual potential. Review of technique and outcomes of treated patients. The surgical technique involved superficial epithelial keratectomy, corneal cautery, amniotic membrane transplantation, and temporary bandage contact lens placement. Four patients were treated with this technique. All had significant pain due to bullous keratopathy before the surgery. After a mean follow-up of 16 months (1-42), 3 patients reported complete resolution of pain, and an examination disclosed a smoother corneal surface without bullae. One patient had recurrent pain after the removal of his bandage contact lens 1 month after the surgery. Separation of the amniotic membrane from the underlying cornea was noted. The patient underwent incision of the amniotic membrane with drainage of the fluid and is currently stable. Superficial epithelial keratectomy, cautery, and amniotic membrane transplantation can be used to treat painful bullous keratopathy in a minimally invasive fashion with improved cosmetic results.