Clinical Outcomes Of Brightmem Anterior Keratoplasty For Complex Ocular Surface Disease

To evaluate ocular surface stabilization, epithelial healing, visual outcomes, and ocular comfort following BrightMEM Anterior Keratoplasty (BMAK) in patients with complex anterior corneal pathology.

Single tertiary academic center. 

A retrospective review was performed of eyes undergoing BMAK at our institute. Data collected included demographics, surgical indication, preoperative and postoperative best-corrected visual acuity (BCVA), epithelial healing status, and postoperative pain. Primary outcomes were epithelial healing and change in visual acuity. Secondary outcomes included surface stabilization, need for adjunctive procedures, and postoperative complications.

25 eyes underwent BMAK with a mean patient age of 62.7 ± 14.7 years. The most common indication was limbal stem cell deficiency (LSCD) (32%), followed by LSCD with aniridia (12%), neurotrophic keratopathy (12%), and recurrent corneal erosion (8%). Surface improvement or stabilization occurred in 10 eyes (40%), with partial improvement in 6 eyes (24%). Complete epithelial healing occurred in 6 eyes (24%), while persistent epithelial defects were noted in 13 eyes (52%). 9 eyes (36%) had an uncomplicated postoperative course. Membrane-related issues occurred in 3 eyes (12%), and additional intervention was required in 2 eyes (8%). Visual acuity improved by ≥2 lines in 7 eyes (39%), remained stable in 7 eyes (39%), and declined in 4 eyes (22%).

BMAK demonstrated the ability to stabilize the ocular surface in a subset of eyes with complex anterior corneal pathology. Although complete epithelial healing was not universal, many eyes achieved surface stabilization with modest visual improvement and a relatively low rate of significant complications. BMAK may serve as a useful adjunctive option for managing challenging ocular surface disease.