Bowman's layer transplantation for advanced keratoconus: clinical outcomes up to five years after surgery

Session Details

Session Title: Cornea Surgical II

Session Date/Time: Tuesday 13/09/2016 | 08:00-10:30

Paper Time: 08:58

Venue: Hall C2

First Author: : K.van Dijk THE NETHERLANDS

Co Author(s): :    I Dapena   J. Parker   E. Groeneveld   G. Melles           

Abstract Details

Purpose:

To evaluate the mid-term clinical results of Bowman layer transplantation, a new surgical technique to reduce and stabilize ectasia in eyes with advanced keratoconus, to postpone penetrating or deep anterior lamellar keratoplasty and to enable continued contact lens wear.

Setting:

Netherlands Institute for Innovative Ocular Surgery/tertiary referral center

Methods:

In twenty-two eyes of 19 patients with progressive, advanced keratoconus, not eligible for UV-crosslinking, a mid-stromal manual dissection was performed and an isolated donor Bowman layer was positioned within the stromal pocket. Before and up to 60 months after surgery, best spectacle-corrected visual acuity (BSCVA), best contact lens-corrected visual acuity (BCLVA), Scheimpflug-based corneal tomography measurements, endothelial cell density, biomicroscopy, and intra- and postoperative complications were evaluated.

Results:

Mean maximum keratometry decreased on average from 77.2 (±6.2) D to 69.2 (±3.7) D at one month after surgery (P<.05), and remained stable thereafter (P>.05). Mean LogMar BSCVA improved from 1.27 (±0.44) before to 0.90 (±0.30) 12 months after surgery (P<.05), and stabilization thereafter (P>.05). During the whole follow-up period no change in mean BCLVA was observed (P>.05). Pachymetry increased from before to one month postoperatively (P<.05), after which no changes were found (P>.05). No postoperative complications were observed, and endothelial cell density remained stable from before to after the surgery (P>.05).

Conclusions:

With isolated Bowman layer transplantation, reduction of corneal ectasia and stabilization up to five years thereafter was achieved in eyes with progressive, advanced keratoconus. The procedure may be performed to postpone penetrating or deep anterior lamellar keratoplasty.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a competing company