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Anterior stromal puncture in the treatment of bullous keratopathy

Purpose: To evaluate the effect of anterior stromal puncture to treat bullous keratopathy patients (BK) who were symptomatic. Methods: Twenty-five patients with BK and decreased vision, awaiting or not penetrating keratoplasty, were evaluated before, 1, 4 and 12 weeks after anterior stromal punctures performed with a # 25 needle. The patients were asked about pain intensity, foreign body sensation and photophobia. Biomicroscopy, esthesiometry and pachymetry results were evaluated. Results: The comparisons between results before and after the anterior stromal puncture related to pain (p<0.001), photophobia (p=0.0198), foreign-body sensation (p<0.001), insomnia (p=0.0015) and esthesiometry (p=0.00654) showed significant statistical differences regarding decreasing symptoms and corneal sensitivity. The mean pachymetry did not show a statistical difference between results before and after the procedure (p=0.873). We did not find important differences in terms of corneal neovascularization. Conclusion: Anterior stromal puncture is an effective, simple and low cost alternative to treat symptomatic patients with BK.

Bullous keratopathy; Corneal edema; Treatment


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