Efficacy of Anterior Stromal Puncture Surgery with Corneal Bandage Lens for Bullous Keratopathy

Abstract

Objective: To investigate the safety and efficacy of the combination therapy of anterior stromal puncture (ASP) with bandage contact lens for bullous keratopathy (BK). Methods: Twelve cases (12 eyes) with vision acuity no better than light perception were treated with ASP surgery and bandage contact lens. 200 points punctures were made through the corneal epithelium and Bowman's layer vertically, using fine needles. A soft bandage contact lens was applied immediately and removed 2 weeks later. The severity of irrigating symptoms including pain, photophobia and tearing was graded and calculated before treatment and 1, 2, 4, 12 weeks after the surgery, slit-lamp microscope examination was used to quantify the time for corneal epithelial blisters disappearing, optical coherence tomography (OCT) was used to monitor the central corneal thickness. Results : No cornea infection was observed during the following up period. The average grade scores of the irrigating symptoms was 8.3 ± 2.1 before surgery, while it was reduced to 4.8 ±1.9 two weeks after the surgery (p=0.0003). Slit-lamp microscope examination showed that corneal edema relieved obviously after the operation, the average time for epithelial blisters disappearing was 15.6 ± 4.0 days. The average central corneal thickness of the eyes was 999.3 ±278.0 μm before the treatment, while it was 805.1 ± 145.0 μm four weeks after the treatment, with a statistically significant difference (p=0.043). Conclusions : ASP with bandage contact lens is an effective and safe treatment for patients with BK and low vision that not suitable for corneal transplantation.

Effect of sodium hyaluronate eye drops combined with tobramycin, dexamethasone and pranoprofen eye drops in the treatment of dry eye after phacoemulsification

“…Studies show that when combined, sodium hyaluronate, tobramycin, dexamethasone, and pranoprofen act synergistically to reduce the ocular inflammatory response and shorten the incision healing time, thus keeping the eyes moist, promoting corneal and conjunctival repairs, and improving the ocular circulation, to achieve an optimal curative effect. [ 26 27 ] Consistently with these observations, we found that the addition of sodium hyaluronate to the post-phacoemulsification treatment regimen was associated with a markedly improved effective rate in patients with postoperative dry eye. Moreover, it resulted in an over 1.8-fold increase in the rate of complete cure as compared to patients who received the conventional treatment with tobramycin, dexamethasone, and pranoprofen only.…”

In Vivo Confocal Microscopy Findings After Anterior Stromal Puncture in the Treatment of Recurrent Corneal Erosion Syndrome

“…ASP was first used in the treatment of RCE in 1986 by McLean et al( 8 ) and comparative studies have been conducted to evaluate the effectiveness of this procedure, alone or in combination with other treatment options ( 5 , 9 - 11 ). Despite successful reports of ASP for RCE, the mechanism of how the procedure works on the cellular level is still unknown, and there are only few reports on the process of healing with ASP; a study reported in 1990 investigated the healing process after ASP by electron microscopy in rabbit corneas with recurrent erosion ( 12 ).…”