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Br J Ophthalmol. 2013 Aug;97(8):980-4. doi: 10.1136/bjophthalmol-2013-303081. Epub 2013 May 30.

Amniotic membrane transplantation versus anterior stromal puncture in bullous keratopathy: a comparative study.

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External Eye Disease and Cornea Service, Department of Ophthalmology, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Sao Paulo, Brazil.



To compare amniotic membrane transplantation (AMT) and anterior stromal puncture (ASP) in the management of pain in patients with symptomatic bullous keratopathy (BK).


In this prospective comparative study, 40 eyes of 40 patients with symptomatic BK (chronic intermittent pain) were randomised and divided into two groups (AMT and ASP) according to the technique used to treat symptomatic BK. The patients were examined on days 1, 14, 30, 90 and 180 postoperatively. Patients with BK under the age of 18 with raised eye pressure, concurrent ocular surface infection and those without any pain were excluded.


At follow-up at 90 and 180 days the presence of a regular epithelial surface was higher in the AMT group (60% and 50%, respectively) than in the ASP group (16.7% and 6. 3%, p=0.006 and p=0.008, respectively). At 180 days follow-up there was no statistical difference between the two groups in the severity (p=0.391) or duration (p=0.715) of pain.


AMT is similar to ASP in the relief of pain in symptomatic BK. However, ASP is a simple outpatient procedure and should cost less than AMT. NCT 00659308.


Cornea; Ocular surface; Treatment Surgery

[Indexed for MEDLINE]

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