Symptomatic management of postoperative bullous keratopathy with nonpreserved human amniotic membrane

To report the results of the management of painfully symptomatic postoperative bullous keratopathy (PBK) by performing a nonpreserved human amniotic membrane (NP-AMT) transplantation in nine eyes with poor visual potential.

A prospective, comparative, nonrandomized management of symptomatic PBK was done by performing a complete corneal de-epithelialization followed by a NP-AMT transplantation (NP-AMT group) or no NP-AMT transplantation (control group). We evaluated time for re-epithelialization, patient's symptoms, and appearance of new bullae.

In the NP-AMT group, mean follow-up time was 40 weeks. Mean re-epithelialization time was 11.2 days. Symptoms of PBK resolved completely in eight patients (88%), who were asymptomatic and showing very quiet eyes from postoperative day 1, and resolved partially in one patient in whom we observed barely symptomatic bullae at the peripheral NP-AMT border (sixth postoperative week) and an asymptomatic one at the corneal center under the NP-AMT (seventh postoperative week). In the control group, mean follow-up time was 18 weeks; there were recurrences of symptomatic bullae in four of five patients at a mean time of 6.3 days.

NP-AMT is a good alternative for the management of painful PBK in eyes with poor visual potential; NP-AMT is widely available, the technique is easy to perform, and it has good results from both the symptomatic and esthetic standpoint.