Electrocautery of Bowman's membrane for bullous keratopathy

Eletrocauterização da membrana de Bowman no tratamento da ceratopatia bolhosa

RESUMO

Purpose:

To evaluate the effectiveness and safety of an old procedure (Salleras procedure) in patients with APBK and poor visual prognosis regarding biomicroscopic, histopathologic and tonometric findings.

Patients and Methods:

Eight consecutive patients with APBK were included and followed up for 3 months. Biomicroscopy and tonometry were taken preoperatively and postoperatively (PO 1,3,7,15,30,60 and 90). One patient underwent penetrating keratoplasty and the button was sent to the pathologist.

Results:

All the patients presented corneal healing in 4 weeks. Their main complaint before the procedure (excruciating pain), was completely alleviatet after the corneal healing. There were no IOP increasing out of normal patterns. Histopathologic study showed that the mechanism of action related to this technique is related to formation of a dense connective tissue, that acts as a physical barrier to fluid penetration from the stroma to the epithelium.

Conclusion:

Besides all technology, electrocautery of Bowman's membrane is still a reliable procedure to treat patients with severe pain and poor visual prognosis in APBK.

Key words:
Salleras procedure; Bullous keratopathy; Corneal surgery

RESUMO

Ceratopatia bolhosa dolorosa avançada em pacientes não controlados clinicamente e portadores de doenças oculares com mau prognóstico visual, como descolamento antigo de retina e doenças crônicas do vítreo, nos quais o alívio da dor é o principal objetivo, podem se beneficiar de uma antiga, mas eficaz e acessível forma de tratamento, a eletrocauterização da Membrana de Bowman (Procedimento de Salleras).

Realizamos estudo prospectivo em 8 pacientes consecutivos submetidos ao procedimento no tocante à biomicroscopia, tonometria e histopatologia.

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REFERENCES

• ¹
  Salleras. Bullous Keratopathy. In: King JH and McTigue JW eds. The Cornea, World Congress, Washington D.C.: Butterworth & Co, 1965, p.292-9.
• ²
  Leibowitz HM, Rosenthal PR. Hydrophilic contact lenses in corneal disease, 11: bullous keratopathy. Arch Ophthalmol 1971;85:283-5.
• ³
  Gundersen T. Conjunctival flaps in the treatment of corneal disease with reference to a new technique of application. Arch Ophthalmol 1958;60:880-8.
• ⁴
  Parker WR. Galvanocautery in bullous keratitis. Ophthal Rec 1894-1895; 4:66-9.
• ⁵
  De Voe AG. Electrocautery of Bowman's membrane. Arch Ophthalmol 1966; 76:768-71.
• ⁶
  Koenig SB. Annular keratotomy for the treatment of painful bullous keratopathy. Am J Ophthalmol 1996;121: 93-4.

Publication Dates

• Publication in this collection
  Feb 1998