LASIK MD Correction de la vue au laser – Article "Amniotic Membrane Transplantation for Patients with Painful Bullous Keratopathy Awaiting Penetrating Keratoplasty"
(L'article est en anglais)
Abstract Title: Amniotic
Membrane Transplantation for Patients with Painful Bullous
Keratopathy Awaiting Penetrating Keratoplasty
Author Block: L.Racine, P.E. Demers, P.Thompson.
Ophthalmology, Université de Montréal, Montreal, QC,
Canada
Purpose: To evaluate the effectiveness of amniotic
membrane transplantation (AMT) in the management of patients with
painful pseudophakic bullous keratopathy (PBK) awaiting penetrating
keratoplasty (PKP) after failure of conventional therapy.
Methods: AMT, using preserved amniotic membrane
(AM),was performed in 12 eyes of 12 patients whose age ranged from
60 to 88 years (mean 75), awaiting PKP for painful PBK despite
conventional treatment (ointments, bandage contact lens). Surgical
technique consisted in a superficial keratectomy up to 1 mm
anterior to the limbus and placement of the AM on the corneal bed
with the basement membrane facing up. The AM was attached with four
interrupted sutures and a 10.0 nylon running suture. Pain was
evaluated using a visual analog scale (VAS) and assessed
preoperatively and postoperatively at 2 weeks and at 1, 3, 6 and 12
months. A subjective questionnaire was also used to assess levels
of pain, photophobia and foreign body sensation.
Results: There was a significant reduction in pain
experienced at the 2-week visit (mean VAS 5.58 +/- 6.35 units (p =
0.014)) when compared to preoperative levels (mean VAS 14.67 +/-
4.38 units). Pain scores were constant throughout the study period
(12-month mean VAS 5.42 +/- 5.70 units (p = 0.01)). Answers to the
subjective questionnaire showed that at 6 months, a significant
reduction in pain (p = 0.03) foreign body sensation (p = 0.05), and
photophobia (p = 0.044) were noted. However, at 12 months, only
pain was still noted to be significantly reduced (p = 0.003).
Conclusions: AMT is effective in alleviating pain
in patients with symptomatic PBK refractory to conventional medical
therapy.
