The Efficacy of Amniotic Membrane Graft in the Treatment of Symptomatic Bullous Keratopathy

Abstract

Purpose: To evaluate the efficacy of amniotic membrane (AM) transplantation in symptomatic bullous keratopathy using cryo-preserved or lyophilized AM. Methods: Eight bullous keratopathic patients, who experienced intractable pain despite medication and the application of a therapeutic lens, underwent permanent AM transplantation with 5 cryo-preserved and 3 lyophilized AMs following removal of epithelium using a trephine. The time to re-epithelization and the subsidence of pain were evaluated retrospectively. Results: Mean follow-up was 252±171.0 days. Pain relief and re-epithelization were obtained in all eight patients. The times to complete relief of pain was 32.2±22.7 days in patients with cryo-preserved AM transplantations (n=5) and 22.0±18.0 days in those with lyophilized AM transplantations (n=3) (p=0.549, Mann-Whitney U test). Respective times to re-epithelization were 25.4±20.7 days and 23.0±25.2 days (p=0.297). There were no significant differences in the diameter of transplanted AMs between the two groups (7.6±0.2 vs. 7.3±0.3 mm, p=0.172). Conclusions: Permanent AM transplantation effectively reduced the intractable pain caused by epithelial bulla. Whether the AM was cryo-preserved or lyophilized did not affect the efficacy of the treatment.