PURPOSE: The purpose of this study was to investigate the outcome of combined phototherapeutic keratectomy and amniotic membrane grafting in the management of painful symptomatic bullous keratopathy. METHODS: We conducted a retrospective consecutive interventional case series. Combined phototherapeutic keratectomy and amniotic membrane grafting was performed in 18 eyes of 17 patients who were symptomatic because of bullous keratopathy. Data analysis was done for only 12 eyes that were followed up for more than 5 weeks and when the postoperative status of the amniotic membrane was known. RESULTS: The mean preoperative duration of the symptoms was 164.17 +/- 179.39 weeks (range, 24-480 weeks). Eleven of 12 eyes (91.67%) were totally symptom-free during the entire postoperative follow-up period of 38.08 +/- 47.95 weeks (range, 5-156 weeks). One patient (8.33%) had mild irritation, which had started at his last postoperative follow up, at 8 months. His amniotic membrane had absorbed at 16 weeks. The amniotic membrane was completely absorbed in 58.33% (7 of 12 eyes) of eyes, partially absorbed in 33.33% eyes (4 of 12 eyes), and not absorbed at all in one eye (8.33 %). None of the patients required any repeat or additional procedure. CONCLUSION: Phototherapeutic keratectomy when combined with amniotic membrane grafting provides a viable alternative in the management of painful symptomatic bullous keratopathy.
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