Article Text

Download PDFPDF
Amniotic membrane transplantation versus anterior stromal puncture in bullous keratopathy: a comparative study
  1. Fabiana dos Santos Paris1,
  2. Eliana Domingues Gonçalves1,
  3. Mauro Silveira de Queiroz Campos1,
  4. Élcio Hideo Sato1,
  5. Harminder S Dua2,
  6. José Álvaro Pereira Gomes1
  1. 1External Eye Disease and Cornea Service, Department of Ophthalmology, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
  2. 2Division of Ophthalmology and Visual Sciences, University of Nottingham, Nottingham, UK
  1. Correspondence to Dr Fabiana dos Santos Paris, External Eye Disease and Cornea Service, Department of Ophthalmology, Federal University of Sao Paulo (UNIFESP), Av. Pedro de Toledo, 760/94-Palmital-Marília, Sao Paulo, Sao Paulo Cep 17509-020, Brazil;{at}


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

Methods 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.

Results 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.

Conclusions 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

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.