幹細胞研究と治療のジャーナル

概要

Comparative Analysis of Human Amniotic Membrane Graft versus Contact Lenses in Symptomatic Bullous Keratopathy

Venegas L, Hettich M, Villena J, Aris R, Párraga M, Parolini O, Alaminos M, Campos A and San Martin S

Bullous Keratopathy (BK) is a corneal disease involving the production of vesicles, chronic eye pain and visual acuity decrease. Definitive treatment is corneal transplant; however, donated corneas are not always available, and may require a long waiting time. The available palliative treatment is the use of contact lenses, however, this may be associated with corneal neovascularization, lens displacement or loss, infections and discomfort for the patient. Amniotic membrane is a structure obtained from human placenta that has been used in ophthalmology and more recently in novel regenerative medicine approaches mainly for its anti-inflammatory and anti-fibrotic properties, amongst other biological properties. This study compares the use of amniotic membrane grafts versus contact lenses in patients suffering from BK who are waiting for a corneal transplant. A randomized clinical trial study was performed with patients with diagnosis of BK. Twenty patients were randomized into 2 groups: patients treated with amniotic membrane and treated with therapeutic contact lenses. Eye pain intensity (analog visual scale), visual acuity (Snellen test); bullae, corneal epithelial defects, corneal neovascularization and complications (biomicroscopy) were compared during 6 months. In the amniotic membrane-treated group the ocular pain was significantly lower after 7 days (p=0.005) and 30 days (p=0.002) from the surgical procedure as compared to therapeutic contact lenses group, but it increased at day 180 (p=0.042). No statistical differences were observed for the other parameters evaluated. Amniotic membrane is a safe and efficient alternative to the therapeutic contact lenses to short term relief of ocular pain in patients with BK.