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Bowman Layer Transplantation

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Modern Keratoplasty

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

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Abstract

Bowman layer transplantation is a promising new surgical technique for the treatment of advanced, progressive keratoconus in order to postpone or prevent a more invasive corneal surgery. This sutureless procedure uses an acellular Bowman layer graft and avoids the suture and graft-related complications of penetrating or deep anterior lamellar keratoplasty. The technique was first performed intrastromally, as an inlay graft, by transplanting an isolated donor Bowman layer into a manually dissected pocket within the mid-stroma of the pathologic cornea. A more recent technique consists of a Bowman layer graft positioned onto the anterior stroma after epithelium removal, as an onlay graft. In eyes with advanced, progressive keratoconus, both techniques show comparable clinical outcomes in the first postoperative months, resulting in corneal flattening, stabilization against further ectasia, enabling continued contact lens wear with high tolerance, with minimal intraoperative and postoperative complications. In addition, the Bowman layer onlay procedure was successfully applied to reduce superficial corneal scarring and/or anterior corneal irregularities in herpetic keratitis and as a treatment of last resort in patients with recurrent corneal erosions.

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Author information

Authors and Affiliations

  1. Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands

    Achraf Laouani, Lydia van der Star, Silke Oellerich, Korine van Dijk, Gerrit R. J. Melles & Viridiana Kocaba

  2. Melles Cornea Clinic, Rotterdam, The Netherlands

    Achraf Laouani, Lydia van der Star, Korine van Dijk, Gerrit R. J. Melles & Viridiana Kocaba

  3. Amnitrans Eye Bank, Rotterdam, The Netherlands

    Gerrit R. J. Melles & Viridiana Kocaba

  4. Tissue and Cell Therapy Group, Singapore Eye Research Institute, Singapore, Singapore

    Viridiana Kocaba

Authors
  1. Achraf Laouani
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  2. Lydia van der Star
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  3. Silke Oellerich
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  4. Korine van Dijk
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  5. Gerrit R. J. Melles
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  6. Viridiana Kocaba
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Corresponding author

Correspondence to Gerrit R. J. Melles .

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Editors and Affiliations

  1. Vissum Miranza, Miguel Hernández University, Alicante, Spain

    Jorge L. Alió

  2. Vissum-Instituto Oftalmologico de Alica, Miguel Hernandez University, Alicante, Alicante, Spain

    Jorge L. Alió del Barrio

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© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

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Laouani, A., van der Star, L., Oellerich, S., van Dijk, K., Melles, G.R.J., Kocaba, V. (2023). Bowman Layer Transplantation. In: Alió, J.L., del Barrio, J.L.A. (eds) Modern Keratoplasty. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-031-32408-6_17

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  • DOI: https://doi.org/10.1007/978-3-031-32408-6_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-32407-9

  • Online ISBN: 978-3-031-32408-6

  • eBook Packages: MedicineMedicine (R0)

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