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10 - 12 February 2017, MECC Maastricht,The Netherlands.

This Meeting has been awarded 15 CME credits.


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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


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.


Netherlands Institute for Innovative Ocular Surgery / Tertiary referral center


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.


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.


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

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