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Bowman Layer Transplantation for Advanced Keratoconus

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Controversies in the Management of Keratoconus

Abstract

Penetrating and – to some extent, Deep anterior lamellar keratoplasty (PK and DALK, respectively) – represent the ‘old’ generation of treatments for keratoconus (KC). Increasingly, they are being replaced by newer, less invasive techniques, like ultra-violet corneal crosslinking (UV-CXL) and intracorneal ring segment (ICRS) implantation. Even more recently, Bowman layer (BL) transplantation has been introduced for patients with advanced KC; the operation is designed to stiffen, strengthen, and flatten the recipient cornea into a more normal, stable configuration and thereby prevent or delay the need for more invasive treatment. Here, we provide an overview and history of this new technique, and relay the operation’s mid-term surgical results.

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References

  1. van Dijk K, Liarakos VS, Parker J, et al. Bowman layer transplantation to reduce and stabilize progressive, advanced keratoconus. Ophthalmology. 2015;122:909–17.

    Article  Google Scholar 

  2. van Dijk K, Parker J, Tong CM, et al. Midstromal isolated Bowman layer graft for reduction of advanced keratoconus: a technique to postpone penetrating or deep anterior lamellar keratoplasty. JAMA Ophthalmol. 2014;132:495–501.

    Article  Google Scholar 

  3. Parker JS, van Dijk K, Melles GR. Treatment options for advanced keratoconus: a review. Surv Ophthalmol. 2015;60:459–80.

    Article  Google Scholar 

  4. Pramanik S, Musch DC, Sutphin JE, Farjo AA. Extended long-term outcomes of penetratingkeratoplasty for keratoconus. Ophthalmology. 2006;113:1633–8.

    Article  Google Scholar 

  5. Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol. 2003;135:620–7.

    Article  CAS  Google Scholar 

  6. Wollensak G, Spoerl E, Wilsch M, Seiler T. Endothelial cell damage after riboflavin ultraviolet-A treatment in the rabbit. J Cataract Refract Surg. 2003;29:1786–90.

    Article  Google Scholar 

  7. Medical Advisory Secretariat. Intrastromal corneal ring implants for corneal thinning disorders: an evidence-based analysis. Ont Health Technol Assess Ser. 2009;9:1–90.

    PubMed Central  Google Scholar 

  8. Alió JL, Vega-Estrada A, Esperanza S, et al. Intrastromal corneal ring segments: how successful is the surgical treatment of keratoconus? Middle East Afr J Ophthalmol. 2014;21:3–9.

    Article  Google Scholar 

  9. Alió JL, Shabayek MH, Belda JI, et al. Analysis of results related to good and bad outcomes of Intacs implantation for keratoconus correction. J Cataract Refract Surg. 2006;32:756–61.

    Article  Google Scholar 

  10. Lie J, Droutsas K, Ham L, et al. Isolated Bowman layer transplantation to manage persistent subepithelial haze after excimer laser surface ablation. J Cataract Refract Surg. 2010;36:1036–41.

    Article  Google Scholar 

  11. Groeneveld-van Beek EA, Parker J, Lie JT, et al. Donor tissue preparation for Bowman layer transplantation. Cornea. 2016;35:1499–502.

    Article  Google Scholar 

  12. Melles GRJ, Lander F, Rietveld FJR, et al. A new surgical technique for deep, anterior lamellar keratoplasty. Br J Ophthalmol. 1999;83:327–33.

    Article  CAS  Google Scholar 

  13. Luceri S, Parker J, Dapena I, et al. Corneal densitometry and higher order aberrations after Bowman layer transplantation: 1-year results. Cornea. 2016;35:959–66.

    Article  Google Scholar 

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Financial Disclosure

Dr. Melles is consultant for DORC International and SurgiCube International. Drs. Parker, Baydoun, and Dapena are consultants for DORC International. No other author has a financial or proprietary interest in any material or method mentioned.

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Correspondence to Gerrit R. J. Melles .

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Parker, J.S. et al. (2019). Bowman Layer Transplantation for Advanced Keratoconus. In: Barbara, A. (eds) Controversies in the Management of Keratoconus . Springer, Cham. https://doi.org/10.1007/978-3-319-98032-4_27

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  • DOI: https://doi.org/10.1007/978-3-319-98032-4_27

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98031-7

  • Online ISBN: 978-3-319-98032-4

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