Phototherapeutic Keratectomy with or without Amniotic Membrane Transplantation for Symptomatic Bullous Keratopathy

ABSTRACT

PURPOSE: We evaluated the therapeutic effects of phototherapeutic keratectomy (PTK) with or without amniotic membrane transplantation (AMT) in patients who had symptomatic bullous keratopathy with poor visual potential. METHODS: Twenty-five eyes of 25 patients with bullous keratopathy were reviewed retrospectively. Ten eyes (group A) were treated with PTK, and the other 15 eyes (group B) were treated with combined PTK and AMT. Changes of vision and symptoms, re-epithelization time, recurrence of bulla, central corneal thickness measured by anterior segment optical coherence tomography, and postoperative complications were analyzed. RESULTS: At post-operative 3 months, visual acuity improved in 2 patients in both A and B groups. Nine patients in group A (90%) and 13 patients in group B (86.7%) showed symptom improvement. Mean re-epithelization time was 12.40 +/- 4.33 days in group A and 8.13 +/- 1.19 days in group B (p > 0.05). In both groups, central corneal thickness decreased postoperatively without statistically significant difference between groups. At the final follow-up visit, epithelial bulla had not recurred in 7 eyes (70.0%) in group A and 12 eyes (80.0%) in group B. No postoperative complication was detected. CONCLUSIONS: PTK alone appears comparable to the combined treatment of PTK and AMT in terms of symptom improvement, re-epithelization time and recurrence rate.