Int J Med Sci 2019; 16(5):660-664. doi:10.7150/ijms.31669 This issue

Research Paper

Efficacy of Anterior Stromal Puncture Surgery with Corneal Bandage Lens for Bullous Keratopathy

Guigang Li1, Jiao Zheng2,3, Jin Gong2,3, Alataree Sameer1, Xinyu Li1, Yuan Zhang4, Sean Tighe4, Yingting Zhu4, Ping Wang2,3✉

1. Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China.
2. Department of Ophthalmology, Renhe Hospital affiliated to Three Gorges University, Yichang, Hubei Province, 443001, China.
3. Eye institute, Three Gorges University, Yichang, Hubei Province, 443001, China.
4. Tissue Tech, Inc., Miami, FL, 33126, USA.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license ( See for full terms and conditions.
Li G, Zheng J, Gong J, Sameer A, Li X, Zhang Y, Tighe S, Zhu Y, Wang P. Efficacy of Anterior Stromal Puncture Surgery with Corneal Bandage Lens for Bullous Keratopathy. Int J Med Sci 2019; 16(5):660-664. doi:10.7150/ijms.31669. Available from

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Objective: To investigate the safety and efficacy of the combination therapy of anterior stromal puncture (ASP) with bandage contact lens for bullous keratopathy (BK).

Methods: Twelve cases (12 eyes) with vision acuity no better than light perception were treated with ASP surgery and bandage contact lens. 200 points punctures were made through the corneal epithelium and Bowman's layer vertically, using fine needles. A soft bandage contact lens was applied immediately and removed 2 weeks later. The severity of irrigating symptoms including pain, photophobia and tearing was graded and calculated before treatment and 1, 2, 4, 12 weeks after the surgery, slit-lamp microscope examination was used to quantify the time for corneal epithelial blisters disappearing, optical coherence tomography (OCT) was used to monitor the central corneal thickness.

Results: No cornea infection was observed during the following up period. The average grade scores of the irrigating symptoms was 8.3 ± 2.1 before surgery, while it was reduced to 4.8 ±1.9 two weeks after the surgery (p=0.0003). Slit-lamp microscope examination showed that corneal edema relieved obviously after the operation, the average time for epithelial blisters disappearing was 15.6 ± 4.0 days. The average central corneal thickness of the eyes was 999.3 ±278.0 μm before the treatment, while it was 805.1 ± 145.0 μm four weeks after the treatment, with a statistically significant difference (p=0.043).

Conclusions: ASP with bandage contact lens is an effective and safe treatment for patients with BK and low vision that not suitable for corneal transplantation.

Keywords: anterior stromal puncture, bandage contact lens, bullous keratopathy