7 Cases of Combined Corneal Tattooing and Amniotic Membrane Transplantation in Bullous Keratopathy

Yong Kyu Kim; Young Keun Han; Won Ryang Wee; Jin Hak Lee; Ji Won Kwon

doi:10.3341/jkos.2008.49.3.503

Journal List > J Korean Ophthalmol Soc > v.49(3) > 1008219

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Kim, Han, Wee, Lee, and Kwon: 7 Cases of Combined Corneal Tattooing and Amniotic Membrane Transplantation in Bullous Keratopathy

Original Article

J Korean Ophthalmol Soc 2008;49(3):503-508.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.3.503

7 Cases of Combined Corneal Tattooing and Amniotic Membrane Transplantation in Bullous Keratopathy

Yong Kyu Kim, M.D.¹, Young Keun Han, M.D.², Won Ryang Wee, M.D.¹, Jin Hak Lee, M.D.³, Ji Won Kwon, M.D.^1,⁴

¹Department of Ophthalmology, Seoul National University College of Medicine, Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea

²Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul, Korea

³Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

⁴Seoul National University Hospital, Health Care System Gangnam Center, Healthcare Research Institute, Seoul, Korea

Address reprint requests to Ji Won Kwon, M.D. Department of Ophthalmology, Seoul National University College of Medicine #28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea Tel: 82-2-2072-2438, Fax: 82-2-741-3187, E-mail: eyeminerva@yahoo.co.kr

Received 20 March 2007 Accepted 21 September 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report on the clinical efficacy of the combined operation of corneal tattooing and amniotic membrane transplantation on the treatment of bullous keratopathy in patients with poor visual potentials.

Case summary

We performed corneal tattooing and amniotic membrane transplantation in 7 eyes with bullous keratopathy. Postoperatively, we assessed the status of corneal reepithelialization, postoperative pain, and cosmetic effects. In all cases but one, corneal reepithelialization was successful without pain, and the corneal tattooing persisted throughout the follow-up period. In one case, a corneal epithelial defect developed, so we performed an additional amniotic membrane transplantation. After 2 weeks, the corneal epithelial defect healed and caused no further pain.

Conclusions

The combined operation of corneal tattooing and amniotic membrane transplantation is a good choice for the treatment of bullous keratopathy with regard to cosmetic problems, pain, and poor visual potential.

Keywords: Amniotic membrane transplantation, Bullous keratopathy, Corneal tattooing

References

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Figure 1.

Thick corneal epithelium (A) with stromal fibro-collagenous change (B). (H&E, ×40)

Figure 2.

Haphazardly proliferated fibroblasts in the stroma. (H&E, ×200)

Figure 3.

A 50 year-old man with pseudophakic bullous keratopathy. Preoperative photograph (A) and postoperative photograph (B). (case 1)

Figure 4.

A 44 year-old man with recurrent bullous keratopathy. Preoperative photograph (A, B) and postoperative photograph (C, D). (case 4)

Table 1.

Data of bullous keratopathy patients who underwent combined corneal tattooing and amniotic membrane ransplantation

Case No.	Age	Sex	Cause of bullous keratopathy	Postoperative follow up period (month)	Epithelialization (week)	Pain 1 wk after the operation	Pain at last visit	Cosmesis
1	50	M	Pseudophakia	24	2	No	No	Good
2	55	M	Pseudophakia	11	4	No	No	Good
3	56	F	Glaucoma	8	10^*	No	No	Good
4	44	M	Pseudophakia	7.5	4	Mild	No	Good
5	19	M	Glaucoma	7	4	No	No	Good
6	51	M	Glaucoma	3	3	No	No	Good
7	46	M	Trauma	3	4	No	No	Good

^* Corneal epithelial defect persisted, so additional amniotic membrane transplantation was done. Corneal epithelial defect mproved within 2 weeks after the amniotic membrane transplantation.

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