Bowman's layer transplantation in advanced keratoconus; 18-months outcomes.
Int Ophthalmol
; 42(4): 1161-1173, 2022 Apr.
Article
em En
| MEDLINE
| ID: mdl-34767125
ABSTRACT
PURPOSE:
To assess the outcome of isolated Bowman's layer transplantation (BLT) in advanced keratoconus in the patients not suitable for ultra violet cross-linking and intra stromal corneal ring segments. STUDYDESIGN:
Nonrandomized Quasi-Experimental. MATERIALS ANDMETHODS:
Mid corneal stromal dissection followed by implantation of manually isolated bowman layer from a donor into the recipient stromal pocket was performed in the Department of Ophthalmology Khyber Teaching Hospital Peshawar from September 2018 to October 2018 and followed up over 18 months.RESULTS:
Eleven eyes of 11 patients, 8 male and 3 female within the age range of 7-28 years with progressive keratoconus went under BLT All keratometry values decreased after surgery. Mean anterior pre-operative SimK changed from 69.05 ± 10.85 D to 61.14 ± 6.23 D at 18 months post-operatively (P = 0.005). Means pre-operative Kmax value decreased from 77.24 ± 7.58 D to 71.07 ± 5.37 D at 18 months post-operatively (p = 0.060). The mean pre-operative posterior keratometry value changed from - 10.03 ± 0.88 to - 8.96 ± 1.06 D at 18 months post-operatively (P = 0.002). Mean pre-operative thinnest corneal thickness increased from 281.64 ± 196.86 um to 355.27 ± 19.17 um at 18th months post-operatively (P = 0.001). Pachymetry p-value pre-operative to 18 months (P = 0.001) was statistically significant. Mean anterior SimK at 6 months post-operatively, 60.55 ± 5.56D changed to 61.14 ± 6.23D at 18 months post-operatively (P = 0.000), Kmax at 6 months postoperative 71.60 ± 5.01 D changed to 71.07 ± 5.37 D at 18 months post-operatively (P = 0.008). Both anterior K values at 6 months and 18 months post-operatively showed less significant change, and the same was true for Kmax data at 6 months and 18 months post-operatively. P-values at 6 months to 18 months post-operatively for cornea back data remained (P = 0.001) unchanged. No complications were observed intra-operatively or post-operatively.CONCLUSION:
Bowman layer transplantation is a unique surgical treatment for advanced keratoconus to stabilize progressive ectasia with fewer complications avoiding the need for penetrating or deep anterior lamellar keratoplasty.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Transplante de Córnea
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Ceratocone
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article