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Superficial Epithelial Keratectomy, Cautery, and Amniotic Membrane Transplant for the Treatment of Painful Bullous Keratopathy in Eyes With Poor Visual Potential

Shalabi, Nabeel MD*,†,‡; Karp, Carol L. MD; Aziz, Hassan MD; Jeng, Bennie H. MD§; Galor, Anat MD, MSPH*,†

Cornea:
doi: 10.1097/ICO.0000000000000137
Techniques
Abstract

Purpose: The aim of this study was to report a new technique for the treatment of painful bullous keratopathy in eyes with poor visual potential.

Methods: Review of technique and outcomes of treated patients.

Results: 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.

Conclusions: 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.

Author Information

*Department of Ophthalmology, Miami Veterans Hospital, Miami, FL;

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL;

Faculty of Medicine, Hail University, Hail, Saudi Arabia; and

§Department of Ophthalmology, University of Maryland, Baltimore, MD.

Reprints: Anat Galor, Department of Ophthalmology, Miami VAMC, 1201 NW 16th Ave, Miami, FL 33125 (e-mail: agalor@med.miami.edu).

The authors have no conflicts of interest to disclose.

Supported by VA career development award (A.G.), NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, Department of Defense (DOD-Grant#W81XWH-09-1-0675).

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.corneajrnl.com).

Received October 24, 2013

Accepted March 23, 2014

© 2014 by Lippincott Williams & Wilkins.