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Outcome of Bowman's layer transplant in a referral hospital in the UK

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First Author: T.Mohammad UK

Co Author(s):    A. Tourkmani                    

Abstract Details

Purpose:

To evaluate the visual and surgical outcome of patients with advanced keratoconus who underwent Bowman Layer Transplant (BLT) and compare our results with published data.

Setting:

This study was conducted in Royal Gwent Hospital, Wales, UK. All pre-operative, post-operative assessments and surgical procedure were carried out at a single centre.

Methods:

This was a retrospective study with patients who had stage 3 or 4 keratoconus using Amsler – Krumeich classification, that were unable to tolerate contact lenses (CLs). All patients had preoperative and postoperative visual acuity (VA), corneal topography and anterior segment optical coherence tomography. A single surgeon performed BLT on all patients. Bowman layer was harvested by scoring and peeling and positioned into a manually created mid-stromal pocket. We herein present our 6-month results.

Results:

Eight eyes underwent BLT with an age range of 24-48 years and a mean of 35.8 years. The male to female ratio was 3:1. The mean pre-operative VA was +1.54 Log MAR which improved to a mean postoperative VA of 0.54 Log MAR. The mean of K-Mean improved from pre-operative 66.7D to postoperative 64.9D. Similarly, the mean of K-Max improved from pre-operative 81.2D to postoperative 77.3D. One patient had intraoperative micro perforation who underwent PKP.

Conclusions:

BLT is a novel treatment for advanced keratoconus which may halt or reduce the rate of progression, and also allow patients resume rigid contact lens use, hence avoiding or delaying more invasive procedures. Our early experience with BLT is promising with improvement in VA, and Pentacam measured mean and maximum keratometry. All seven patients who had successful transplant were able to tolerate CLs. Long term follow-up is needed to assess stability over years.

Financial Disclosure:

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