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Bowman layer transplantation to reduce and stabilize progressive and advanced keratoconus

Poster Details

First Author: S.Luceri THE NETHERLANDS

Co Author(s):    K. van Dijk   V. Liarakos   L. Ham   J. Lie   E. Groeneveld-van Beek   G. Melles

Abstract Details


To evaluate the clinical outcome of mid-stromal isolated Bowman layer transplantation, a new surgical technique to reduce and stabilize ectasia in eyes with advanced keratoconus, to postpone penetrating keratoplasty or deep anterior lamellar keratoplasty and to enable continued daily contact lens wear.


Netherlands Institute for Innovative Ocular Surgery/tertiary referral center


In twenty-two eyes of 19 patients with progressive, advanced keratoconus, not eligible for UV-crosslinking, a mid-stromal manual dissection was made and an isolated donor Bowman layer was positioned within the stromal pocket. Before and up to 60 months after surgery, best spectacle-corrected visual acuity (BSCVA), best contact lens-corrected visual acuity (BCLVA), Scheimpflug-based corneal tomography measurements, endothelial cell density, biomicroscopy, refraction, and intra- and postoperative complications were recorded.


Maximum keratometry decreased at one month after surgery (P<.05) and remained stable thereafter (P>.05). Mean LogMar BSCVA improved after surgery (P<.05), while BCLVA remained stable (P>.05). No change in endothelial cell density was found (P>.05), and no postoperative complications were observed.


With isolated Bowman layer transplantation, reduction and stabilization of corneal ectasia was achieved in eyes with progressive, advanced keratoconus. The procedure may be performed to postpone penetrating or deep anterior lamellar keratoplasty- FINANCIAL DISCLOUSRE: One or more of the authors receives consulting fees, retainer, or contract payments from a competing company

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