ESCRS - PO0702 - Histological Comparative Analysis Of Bowman’S Layer Grafts Procured Using Three Different Techniques

Histological Comparative Analysis Of Bowman’S Layer Grafts Procured Using Three Different Techniques

Published 2023 - 41st Congress of the ESCRS

Reference: PO0702 | Type: Free paper | DOI: 10.82333/9ekn-mq94

Authors: Hyeck-Soo Son* 1 , Loren Moon 2 , Jiangxia Wang 3 , Charles G. Eberhart 2 , Albert S. Jun 2 , Divya Srikumaran 2 , Uri S. Soiberman 2

1Ophthalmology,Wilmer Eye Institute,Baltimore,United States;Ophthalmology,University Clinic Heidelberg,Heidelberg,Germany, 2Ophthalmology,Wilmer Eye Institute,Baltimore,United States, 3Biostatistics,Johns Hopkins University Bloomberg School of Public Health,Baltimore,United States

Purpose

To perform a histological analysis of Bowman’s layer (BL) grafts.

Setting

Wilmer Eye Institute, Johns Hopkins Hospital

Methods

BL grafts were procured from 13 human cadaver corneal tissues using three different donor preparation techniques. Subsequently, the grafts were fixed in 10% buffered formalin phosphate and embedded in paraffin. Hematoxylin and eosin (H&E) sections of BL grafts were obtained and analyzed under a light microscope. BL and full graft thickness were measured using an image-processing software.

Results

All 13 BL grafts showed residual anterior stroma. BL stripping using Kelman-McPherson and Moorfield forceps (technique 3) achieved the thinnest graft thickness with mean full-graft thickness of 18.7 µm (95% CI: -9.8-47.2) at the thinnest point of graft, while BL procurement using Melles lamellar dissector (technique 2) led to the highest mean full-graft thickness of 279.9 µm (95% CI: 251.4-308.5). BL dissection using blunt dissector (technique 1) showed mean full-graft thickness of 70.2 µm (95% 40.4-100.1) at the thinnest point. While peripheral graft tear occurred in 50%, 50%, and 100% of techniques 1, 2, and 3, respectively, intact 6.25-mm diameter BL grafts could be secured in 50%, 100%, and 80% of techniques 1, 2, and 3, respectively.

Conclusions

None of the techniques used led to the procurement of pure BL grafts devoid of anterior stroma. Peripheral scoring with a thin needle and tissue manipulation with Kelman-McPherson and Moorfields forceps led to the thinnest grafts in this study.