April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Bowman layer implantation: an alternative to penetrating or deep anterior lamellar keratoplasty in eyes with advanced keratoconus
Author Affiliations & Notes
  • Jack Parker
    Ophthalmology, UAB Callahan Eye Hospital, Birmingham, AL
  • Korine van Dijk
    Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Netherlands
  • Gerrit Melles
    Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Netherlands
  • Footnotes
    Commercial Relationships Jack Parker, None; Korine van Dijk, None; Gerrit Melles, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 3130. doi:
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    • Get Citation

      Jack Parker, Korine van Dijk, Gerrit Melles, ; Bowman layer implantation: an alternative to penetrating or deep anterior lamellar keratoplasty in eyes with advanced keratoconus. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3130.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To evaluate the efficacy of Bowman layer (BL) implantation in reducing and stabilizing corneal ectasia in patients with advanced keratoconus (AKC) and contact lens intolerance, not eligible for either UV-crosslinking (UVCXL) or intracorneal ring segments (ICRS).

 
Methods
 

Ten eyes of 9 patients with AKC and contact lens intolerance, not candidates for either UVCXL or ICRS, underwent mid-stromal implantation of an isolated Bowman membrane and were followed for a mean duration of 16 months.

 
Results
 

All surgeries were uneventful and no complications related to BL implantation were observed. Maximum corneal power decreased, on average, from 74.5D (±7.1D) to 68.3D (±5.6D) (P=0.00). No changes in best corrected visual acuity (P=0.77) or pachymetry (P=0.11) were discovered, and contact lens tolerance was restored in all eyes.

 
Conclusions
 

For eyes with AKC, not candidates for either UVCXL or ICRS, BL implantation may be a safe and effective method of treating ectasia, enabling continued contact lens wear and postponing penetrating or deep anterior lamellar keratoplasty.

 
 
Slitlamp pictures of an eye at 6 months after Bowman layer implantation. The Bowman layer transplant (white arrows) is visible as a thin line within the recipient stroma, without any interface haze or stromal reaction.
 
Slitlamp pictures of an eye at 6 months after Bowman layer implantation. The Bowman layer transplant (white arrows) is visible as a thin line within the recipient stroma, without any interface haze or stromal reaction.
 
 
Scheimpflug images of an eye (A) before and (B) at and twelve months after surgery. (C) When both images are superimposed, the corneal surface contour shows flattening and a better regularity after isolated Bowman layer implantation.
 
Scheimpflug images of an eye (A) before and (B) at and twelve months after surgery. (C) When both images are superimposed, the corneal surface contour shows flattening and a better regularity after isolated Bowman layer implantation.
 
Keywords: 479 cornea: clinical science • 484 cornea: stroma and keratocytes • 765 wound healing  
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