[Show abstract][Hide abstract] ABSTRACT: 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.
The British journal of ophthalmology 05/2013; · 2.92 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate postoperative healing between bandage contact lenses with high and low oxygen permeability in patients having photorefractive keratectomy (PRK).
Center for Refractive Surgery, Walter Reed Army Medical Center, Washington, DC, USA.
This retrospective study compared patients receiving a high-oxygen-transmission bandage contact lens (Focus Night & Day [N&D], Ciba Vision; n = 92) and those receiving a low-oxygen-transmission lens (Proclear, Cooper Vision; n = 114) after PRK. Visual outcomes, safety, and efficacy were assessed postoperatively at 1, 4, and 7 days and 1, 3, 6, and 12 months.
Overall pain scores were higher in the Proclear group at 1 day (P = .000) and 4 days (P = .027). The N&D group had an increase in corneal infiltrates at 4 days (P = .025) and 1 week (P = .017). At 1 month, 40.4% of patients in the Proclear group and 18.6% in the N&D group had a 1 or more line decrease in best spectacle-corrected visual acuity (BSCVA) (P = .002). Although there was a trend toward a higher haze rate in the Proclear group, it was not statistically significant (P = .064). There was no statistically significant difference in uncorrected visual acuity, goal of emmetropia, contrast sensitivity, or reepithelialization.
The N&D lens produced less pain and better postoperative results in terms of haze and BSCVA at 1 month. However, it led to a higher incidence of corneal infiltrates. There was no difference between the lenses in the end result at 12 months.
Journal of Cataract and Refractive Surgery 08/2008; 34(8):1288-94. · 2.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: PURPOSE: To evaluate the therapeutic effect on amniotic membrane transplantation in symptomatic bullous keratopathy. METHODS: Nine patients with symptomatic bullous keratopathy, candidates or not for penetrating keratoplasty were evaluated before, 1, 3, 6 and 12 months after amniotic membrane transplantation. During each visit, patients have been asked about pain, photophobia, and foreign body sensation and were submitted to complete ophthalmological evaluation, esthesiometry and ultrasound pachymetry. RESULTS: Comparing evaluations performed previously and after the procedure regarding pain, photophobia, foreign body sensation and esthesiometry, there was a statistical significant reduction in symptoms and corneal sensitivity. Medium pachymetry showed an increased thickness soon after the procedure and decreasing between 6 and 12 months. It was observed that after 6 months of follow-up, the transplanted amniotic membrane became partially dissolved in 3 cases (33.3%) and totally dissolved in other 3 cases (33.3%). CONCLUSION: Amniotic membrane transplantation represents an effective alternative for the treatment of symptomatic bullous keratopathy up to 12 months of follow-up.
Arquivos Brasileiros de Oftalmologia 12/2002; 66(2):121-124. · 0.44 Impact Factor
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