Journal List > J Korean Ophthalmol Soc > v.48(8) > 1007896

Park, Jeoung, Wee, Lee, Kim, and Lee: 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.

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Figure 1.
A 44 year-old man with diffuse corneal edema and bulla with intractable pain 10 years after cataract extraction and ACL insertion (A). A day after ACL removal, superficial keratectomy and permanent AMT (B). At two months after the operation, the bulla resolved and he had no pain (C).
jkos-48-1036f1.tif
Table 1.
Comparison of the outcomes of permanent amniotic membrane transplantation for the treatment of bullous keratopathy
  Trephine diameter for de-epithelization (mm) Re-epithelization interval (days) Pain relief interval (days)
Cryo-preserved AM 7.6±0.2 25.4±20.7 32.2±22.7
Lyophilized AM 7.3±0.3 23.0±25.2 22.0±18.0
p-value 0.172 0.297 0.549

by Mann-Whitney U test.

The re-epithelization and pain relief of patients who underwent AMT using cryopreserved AM was not different from that of patients who underwent AMT using lyophilized AM. The trephine diameter for de-epithelization was not different between two groups.

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