Posters

Bowman layer onlay transplantation to manage corneal herpes scar

Poster Details

First Author: I.Dapena THE NETHERLANDS

Co Author(s): A. Musayeva   D. Dragnea   E. Groeneveld   S. Ni Dhubhghaill   K. van Dijk   G. Melles     

Abstract Details

Purpose:

To introduce the concept of using a Bowman layer (BL) onlay graft to manage superficial herpetic corneal scarring, and to describe the clinical outcomes of the first two cases undergoing this procedure.

Setting:

Retrospective, interventional cases conducted at the The Netherlands Institute for Innovative Ocular Surgery.

Methods:

Two patients with a quiescent superficial corneal scar after herpes (varicella zoster virus (VZV) n=1 and herpes simplex virus (HSV) n=1) keratitis underwent BL onlay transplantation. After removal of the host epithelium, an isolated BL graft was placed onto the host corneal surface. The cornea was then covered with an amniotic membrane and a bandage lens. Best spectacle- and/or best contact lens-corrected visual acuity (BSCVA and BCLVA), biomicroscopy (BMC), corneal tomography, and anterior segment optical coherence tomography (AS-OCT) were recorded at 1 week, 1 month and at 3, 6, 9, 12 and 18 months postoperatively.

Results:

In both cases, the surgical and postoperative course was uneventful. An improvement of the corneal clarity was observed at BMC and no VZV/HSV reactivation occurred throughout the follow-up period. BMC, Scheimpflug imaging and AS-OCT showed a completely epithelialized and well-integrated graft postoperatively. In the first case, BCLVA with a scleral lens improved from 20/100 (0.1) preoperatively to 20/32 (0.6) postoperatively. For case 2, no preoperative BCLVA was available, but a BCLVA of 20/40 (0.55) was achieved after the procedure.

Conclusions:

A BL onlay graft may be a feasible surgical procedure which may have the potential to reduce superficial corneal scarring and/or anterior corneal irregularities without resorting to deeper keratoplasty in these complex cases.

Financial Disclosure:

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