Amniotic membrane transplantation with anterior stromal micropuncture for treatment of painful bullous keratopathy in eyes with poor visual potential.

Purpose: To report the use of anterior stromal micropuncture and amniotic membrane transplantation in the management of painful bullous keratopathy in patients with poor visual potential.

Methods: Interventional case series. A retrospective review was performed to identify all patients who were treated by one of us (A.J.A.) between January 1, 2003, and June 30, 2005.

Results: Five eyes of 5 patients were identified. Conjunctival scarring secondary to glaucoma and retinal surgeries prevented mobilization of the conjunctiva in each of the patients identified. Each eye showed an intact, smooth corneal epithelial surface 1 month after the procedure, and no patients developed recurrent bullae formation during the follow-up period (average follow-up, 21 months; range, 11-34 months).

Conclusions: Anterior stromal micropuncture and amniotic membrane transplantation is an effective technique for the management of bullous keratopathy in patients with poor visual potential. The success rate of this combined procedure may exceed that of either procedure performed alone.