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Bowman's layer tucking for non-healing, non-infected corneal ulcers

Poster Details

First Author: D.Choudhary INDIA

Co Author(s):                        

Abstract Details


Non-healing corneal ulcers may result from various causes like neurotrophic , neuropathic etc or from corneal irregularities etc. To address some of these issues we have developed a technique of tucking in of Bowman's layer into the anterior stroma which not only covers the defect but also provide a stable smooth surface to corneal epithilium to grow and spread over the defect thus healing the ulcer.


Sawai Man Singh Medical College , JAIPUR , INDIA>


The ulcer is first cleaned of the debri and then a recess is made all around 360 degrees in subepithelium region reaching about 3mm in depth . The harvested Bowman's membrane is cut and fashioned according to the wound size.(about 3mm larger to be embeded into epithelium).The membrane is then spread below the epithelium and slided into the recess with the help of iris repositer. Wound is then covered with a Bandage contact lens. Sutures are usually unnecessary. A preservative free antibiotic and lubricants are all that is required. A short course of cycloplegic ma be added.


To date we have done 5 cases of non healing non infective ulcers.Out of these, 4 have achieved a smooth and strong epithilium with a stable tear film.One case has lost to follow up.


Bowman's layer patching and tucking is promising technique for resistent ulcers as it provides necessary strength and adherence to the layers and a scafold to the epithelium to grow and spread.

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