The application of anterior corneal stromal puncture combined with amniotic membrane patching in corneal diseases

Abstract

Objective To observe the clinical treatment of anterior corneal stromal puncture combined with amniotic membrane patching in bullous keratopathy and rsistent epithelial defects and recurrent corneal erosion. Methods Retrospective case series study. Analysis retrospectively the treatment of bullous keratopathy in 39 cases, 40 eyes in Tangshan ophthalmic hospital from January 2013 to January 2016 which implement anterior corneal stromal puncture combined with amniotic membrane patching. Among them, in 26 cases with bullous keratopathy in 26 eyes including 7 eyes with cataract surgery for glaucoma, 3 eyes with absolute glaucoma period, 5 eyes with vitrectomy, 6 eyes with ocular trauma, 5 eyes with neovascular glaucoma. In 8 cases with rsistent epithelial defects in 8 eyes including 4 eyes with acid burn, 4 eyes with alkali bum. In 5 cases with recurrent corneal erosion in 6 eyes including 2 eyes with Lattice malnutrition, 4 eyes with ocular trauma, 16 cases with patients of diabetes. All patients had obvious pain, tears irritation symptom. When the treatment was invalid after conservative therapy. The anterior corneal stromal puncture combined with amniotic membrane patching was carried out, to observe the eye irritation, corneal epithelial healing,edema of matrix and postoperative visual acuity, and so on. Results Forty eyes in 39 cases were relieved 3 days after the surgery, all patients had no pain and irritation symptoms after amniotic suture removal in 7-10 days. The corneal epithelium was repaired under the slit lamp microscope. One month the bullous keratopathy was recurrence after operation. In one eye which was cured with second anterior corneal stromal puncture. Follow up for 3-6 months, there were no recurrence of keratopathy, corneal epithelium was smooth, no edema, corneal stromal puncture area shallow layer to form a layer of uniform opacitas. The postoperative visual acuity: 22 eyes had no change before and after operation, 18 eyes improved partly. Conclusions The bullous keratopathy patients, resistant epithelial defects and recurrent corneal erosion caused by various factors are treated with anterior corneal stromal puncture combined with amniotic membrane patching, the eye symptom is obviously improved. Not only save the eyeball, but also improve vision on some of the eye. The anterior corneal stromal puncture combined with amniotic membrane patching is a simple, effective and reliable treatment method. Key words: Anterior corneal stromal puncture; Keratopathy; Amniotic membrane patching