Bullous keratopathy - Corneal swelling after eye surgery - A State of Sight #123

Bullous keratopathy is the medical term for swelling of the cornea in the front of the eye that can follow eye surgery. This can cause decreased vision, sensitivity to light, or pain.

Watch this episode of A State of Sight with Isaac Porter, MD to learn more about this problem and some potential treatment options.

Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh. Today, I would like to explain bullous keratopathy, which is an eye problem that causes the cornea to become swollen and cloudy.

This can occur after a patient has had one or multiple eye operations, particularly following cataract surgery, glaucoma surgery, or other procedures in the front of the eye. The risk can be higher if someone has complicated cataract surgery or a cornea that is not very healthy before surgery.

With bullous keratopathy, patients may notice that their vision is cloudy or blurred and they may be sensitive to light. Other symptoms include pain, feeling like something is in their eye, or there may be painful erosions of the surface of the eye.

On examination in the clinic, we can see that the cornea is not clear because it becomes swollen and difficult to see through. The corneal surface may have bullae which are blisters like bubbles of fluid that form underneath the surface of the cornea. These result from fluid and edema pushing out towards the front of the cornea.

In the early or mild stages, patients may be able to treat this problem with a strong saline drop, muro 128, to help reduce the swelling. If this doesn’t improve vision and the edema is persistent or worsening, an inner layer corneal transplant may be necessary to improve vision.

The two primary inner layer (endothelial) corneal transplants that are performed today are DSEK (Descemet’s Stripping Endothelial Keratoplasty) and DMEK (Descemet’s Membrane Endothelial Keratoplasty). Click here if you would like to learn more about these procedures, which can help restore vision that is lost from bullous keratopathy. Following transplantation, we expect the cornea to become clear, vision to improve, and the patients to become comfortable.

Corneal swelling can be a common problem, but we hope that the incidence will decrease as cataract surgery continues to become safer. With advances in cataract surgery including the use of the femtosecond laser and better ways to protect the corneal endothelium, the procedure can be less stressful on the eye.

If you have a problem with corneal swelling or bullous keratopathy, or if you have trouble with your vision and you think it may be related to corneal swelling, please post your questions and we will be happy to answer them. Also, please feel free to give our office a call at 919-876-4064 to request an appointment for examination. Hopefully we will see you again soon next time on A State of Sight.