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    Bowman layer transplantation effective in advanced keratoconus


    In the remaining 18 eyes, BSCVA changed from 1.27 logarithm of the minimum angle of resolution (LOGMAR) before surgery to 0.90 LOGMAR 12 months after the transplantation, a statistically significant different (p < 0.001). After that, no change in BSCVA was observed.

    Average best contact lens-corrected visual acuity (BCLVA) showed no change from before surgery to any time point after.

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    The transplantation caused the most flattening in corneas with a relatively steep Kmax, combined with a flatter SimK and a small corenal apex-to- Kmax distance. This means the procedure worked best in the most advanced cases with the most central cones, the researchers said.

    Because the procedure resulted in stabilization, it might be useful in managing keratoconus cases ineligible for ultraviolet cross-linking, Dr. Parker said.

    Related: Frozen, fresh corneal donor carriers yield similar clinical outcomes

    The main value of the procedure may be that it preserved an acceptable contact lens corrected vision while stabilizing the cornea, he said.

    Researchers have continued to transplant Bowman layers into patients with advanced keratoconus and now have follow-up data on 65 or more, said Dr. Parker.


    This article was adapted from Dr. Parker’s presentation of the Howard Lieberman Memorial Paper at the 2016 meeting of the American Society of Cataract and Refractive Surgery. Dr. Parker has no financial interest relevant to the subject matter.

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