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Bowman Layer Transplantation for Advanced Keratoconus

  • Jack S. Parker
  • Rénuka S. Birbal
  • Korine van Dijk
  • Maya Tong
  • Balamurali Ambati
  • Lamis Baydoun
  • Isabel Dapena
  • Gerrit R. J. Melles
Chapter

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.

Keywords

Cornea Advanced keratoconus Bowman layer Penetrating keratoplasty Deep anterior lamellar keratoplasty Crosslinking Intracorneal ring segments Bowman layer transplantation Corneal transplant Keratoconus Keratoplasty Surgical technique 

Notes

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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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jack S. Parker
    • 1
    • 2
  • Rénuka S. Birbal
    • 1
    • 3
    • 4
  • Korine van Dijk
    • 1
    • 4
  • Maya Tong
    • 1
    • 4
    • 5
  • Balamurali Ambati
    • 6
  • Lamis Baydoun
    • 1
    • 4
  • Isabel Dapena
    • 1
    • 4
  • Gerrit R. J. Melles
    • 1
    • 3
    • 4
  1. 1.Netherlands Institute for Innovative Ocular Surgery (NIIOS)RotterdamThe Netherlands
  2. 2.Parker CorneaBirminghamUSA
  3. 3.Amnitrans EyeBank RotterdamRotterdamThe Netherlands
  4. 4.Melles Cornea Clinic RotterdamRotterdamThe Netherlands
  5. 5.University of AlbertaEdmontonCanada
  6. 6.Pacific Clear Vision InstituteEugeneUSA

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