Treatment of bullous keratopathy by corneal intralamellar therno cauterization combined with radiotomy of corneal nerve and patch grafting of amniotic membrane.

Abstract

Objective To observe the clinical effect of corneal intralamellar thermo cauterization combined with radiotomy of corneal nerve and patch grafting of amniotic membrane to treat bullous keratopathy. Methods Twenty-eight cases (28 eyes) of bullous keratopathy with obvious pain and poor vision were selected, including 16 cases after cataract surgery combined with intraocular lens implantation, 3 cases after cataract surgery, 3 cases after cataract surgery combined with anti-glaucoma surgery,2 cases after anti-glaucoma surgery, 1 case with absolute stage of glaucoma, 2 cases after ocular injury, 1 case after vitrectomy. They were all performed with corneal intralamellar thermo cauterization combined with radiotomy of corneal nerve and patch grafting of amniotic membrane. All cases were followed up for 6～32 months after operation. Results The symptoms of pain disappeared in 25 cases, relieved in 3 cases. The visual acuity was improved in 8 cases, no improved in 20 cases. Amniotic membrane was absorbed or desquamated at 5-45 days postoperatively. Corneal bulla disappeared in 26 cases and area of bulla was reduced in 2 cases. Edema of corneal stroma was also decreased in 28 cases. Following up for 6 to 32 months, there was no recurrence of symptoms or bulla and no occurrence of complications. Conclusions Corneal intralamellar thermo cauterization combined with radiotomy of corneal nerve and patch grafting of amniotic membrane is effective to alleviated clinical symptom of bullous keratopathy with poor visual function. Key words: Bullous keratopathy; Intralamellar thermo cauterization; Radiotomy; Amniotic membrane