Posters

Bowman layer transplantation for advanced keratoconus: graft preparation and clinical outcomes

Poster Details

First Author: E. Groeneveld THE NETHERLANDS

Co Author(s): J. Parker   K. Van Dijk   L. Baydoun   G. Melles           

Abstract Details

Purpose:

To describe a preparation technique for Bowman layer (BL) grafts and to evaluate the mid-term clinical outcomes of BL transplantation for the treatment of advanced keratoconus.

Setting:

Netherlands Institute for Innovative Ocular Surgery / Tertiary referral center

Methods:

BL-grafts (n=22) were prepared from donor globes not eligible for penetrating or endothelial keratoplasty (PK/EK), and from previously excised corneo-scleral buttons which were ineligible for PK, or had been denuded of Descemet membrane (DM) for DMEK-graft preparation. After preparation, grafts were stored in organ culture until the time of surgery. BL transplantation was performed in 22 eyes (19 patients) with progressive, advanced KC by creating a mid-stromal manual dissection and positioning an isolated BL-graft within the stromal pocket. Before and up to 60 months postoperatively, best corrected visual acuity (BCVA), corneal tomography measurements, endothelial cell density, and complications were evaluated.

Results:

No differences were observed between BL-grafts prepared from whole donor globes or corneo-scleral rims with respect to graft preparation success rate. After surgery, maximum keratometry decreased at one month (P<.05) and remained stable thereafter (P>.05). BCVA remained stable (P>.05), and no change in endothelial cell density was found (P>.05). No postoperative complications were observed.

Conclusions:

Isolated BL-grafts can successfully be prepared from both whole donor globes and corneo-scleral rims with equivalent success. In eyes with progressive, advanced keratoconus, BL transplantation achieved reduction and stabilization of corneal ectasia up to 60 months after surgery.

Financial Disclosure:

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