Posters

Femtosecond laser-assisted Bowman's layer transplantation for advanced progressive keratoconus

Poster Details

First Author: L.Zumhagen GERMANY

Co Author(s):    P. Hoffmann                    

Abstract Details

Purpose:

With a prevalence of 1:2.000 Keratoconus is one of the most sight threatening eye disorders in teenager. The progressive course is characterized by breaks in Bowman lamella, stromal thinning and folds or rupture of Descemet membrane. Corneal Crosslinking is the Goldstandard for progressive keratoconus but there is a reasonable number of cases needing an alternative therapeutical approach. The Bowman Layer Transplantation (BLT) technique was presented by Melles in 2015 and is a promising but surgically challenging alternative that should postpone or avoid the need of a keratoplasty. We optimized the surgical procedure by introducing the Femtosecond Laser to the BLT.

Setting:

Augen- und Laserklinik Castrop-Rauxel, Germany

Methods:

The mid-stromal pocket was created assisted by the Bausch & Lomb Victus Femtosecond Laser. The last tissue bridges were then manually dissected with the DORC DALK spatula until a smooth limbus to limbus pocket was prepared. Finally the isolated Bowman Layer was implanted and unfolded according to publication of Melles.

Results:

By the use of the Femtosecond Laser the preparation of the mid-stromal pocket succeeded much safer, easier, more reproducible, accurate and gentle to the ocular tissue. The manual dissection of the last tissue bridges was easy and well guided by the plain of the Femtosecond Laser prepared pocket. Therefore the implantation and unfolding of the Bowman Layer was achieved as atraumatic and smooth as possible. Our first results are comparable to the manual dissection BLT published by Melles.

Conclusions:

BLT is an effective treatment alternative for progressive keratoconus to stabilize ectasia, reduce corneal steepening and improve visual acuity, allowing a better contact lens tolerance and avoid or postpone PKP or DALK in cases where corneal crosslinking is not feasible. The Femtosecond Laser in this BLT setting can be considered as an improvement of easiness, safety, accuracy and reproducibility of preparation of the mid-stromal pocket.

Financial Disclosure:

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