Argon Laser Modified Conjunctivoplasty for Bullous Keratopathy

OBJECTIVE: To find an acceptable surgical procedure to relieve the pain of bullous keratopathy in the interim of waiting for corneal transplantation. STUDY DESIGN: Prospective study of the operative results in 13 eyes with bullous keratopathy were followed up from 7 months to 2 years. SETTING: Naval Eye Clinic, Manila, Philippines. PATIENTS: Thirteen patients with bullous keratopathy following anterior chamber IOLs, phacoemulsification, postPKP and glaucoma. MAIN OUTCOME MEASURES: Relief of pain, visual acuity improvement, cosmetic acceptability, and stability of the procedure. RESULTS: All patients were relieved of pain, appreciated transformation of conjunctiva into semi-transparent membrane with argon laser treatment and reported visual acuity improvement upon creation of an optical window on the graft. CONCLUSION: A horizontal bridge of conjunctival graft is effective in relieving the pain of bullous keratopathy better than any medical treatment or bandage lens. With argon laser treatment, the conjunctiva becomes semi-transparent and cosmetically acceptable. An optical window can be created on the graft to improve vision.