Micropunción estromal anterior en la queratopatía bullosa.

Abstract

Bullous keratopathy is a corneal disease caused by endothelial decompensation secondary to multiple causes as trauma, glaucoma, endothelial dystrophy The results are stromal edema and formation of epithelial or subepithelial bullae. Patients often suffer from pain, photophobia, epiphora and decreased vision. Penetrating keratoplasty is the treatment of choice for bullous kerathopathy. Patients awaiting keratoplasty, or patients in whom surgery is contraindicated or not eligible due to little or no potential for visual recovery, and patients with symptomatic bullous kerathopathy who have lost the motivation for another surgery after repeated graft failures are usually treated with an anterior stromal puncture to relief pain, photophobia and tearing. The use of anterior stromal puncture to treat recurrent corneal erosion is well documented. To date, the mechanisms to explain how anterior stromal puncture reduces pain and induces subepithelial fibrosis are not clear enough. We report 45 cases of bullous kerathopathy treated with anterior stromal puncture. A penetrating keratoplasty was done after in nineteen patients, as well as the histopathologic study of the corneal button.