Amniotic membrane transplantation after the primary surgical management of band keratopathy

Abstract

Purpose. To determine the safety and efficacy of amniotic membrane transplantation to restore and maintain a stable corneal epithelium and reduce ocular surface pain after surgical removal of band keratopathy arising from ocular causes. Methods. Fifteen patients (16 eyes) from two centers with band keratopathy secondary to ocular causes underwent amniotic membrane transplantation as a graft after surgical removal of calcific deposits with or without the use of ethylenediaminetetraacetic acid. In a prospective, consecutive, uncontrolled case series, the rate of corneal epithelialization and resultant surface stability were recorded over a mean follow-up period of 14.6 months. Results. Pain from ocular surface instability was the presenting complaint in 14 of 15 (93.3%) patients and resolved in all cases after the procedure even for those who experienced a recurrence of the calcific deposit. Fifteen of 16 eyes (93.7%) achieved epithelialization with a mean time to epithelial healing of 15.2 days. The only eye that failed to heal was subsequently diagnosed with total limbal stem cell deficiency. Visual acuity improved in five of nine (44%) sighted eyes and remained unchanged in four of nine (56%). No patient experienced any major surgical or medical complication after the procedure. Conclusion. Amniotic membrane transplantation represents a safe and effective method to restore a stable corneal epithelium in eyes after primary surgical removal of band keratopathy arising from ocular causes.