Intracorneal Bowman layer implantation for progressive advanced keratoconus
First Author: VasilisLiarakos GREECE
Co Author(s): Korine van Dijk Jack Parker Peter Ciechanowski Gerrit Melles
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To evaluate the efficacy of Bowman layer (BL) implantation in reducing and stabilizing corneal ectasia in patients with progressive advanced keratoconus (AKC) and contact lens intolerance.
: Netherlands Institute for Innovative Ocular Surgery
Ten eyes of 9 patients with progressive AKC, not eligible for UV-crosslinking, underwent mid-stromal implantation of an isolated Bowman membrane and were followed for a mean of 16 months. Best spectacle corrected visual acuity (BSCVA), maximum and average corneal curvature (Kmax and Kmean) and corneal thickness were recorded at 1, 3, 6, 9 and 12 months postoperatively and every 6 months thereafter.
All surgeries were uneventful and no BL-implantation-related complications were observed. Not only keratoconus was stabilized during follow-up, but there was also a “flattening” effect observed already from the first months. Maximum corneal power decreased on average from 74.5D (±7.1D) to 68.3D (±5.6D) (P<0.001) at last follow-up. BSCVA and corneal thickness did not change significantly (P=0.77 and P=0.11, respectively).
BL implantation may be a safe and effective procedure for preventing further progression and also treating ectasia in AKC, enabling continued contact lens wear and postponing penetrating or deep anterior lamellar keratoplasty. FINANCIAL INTEREST: NONE