Korine van Dijk1,2, Jack S Parker1,2,3, Lamis Baydoun1,2, Abbas Ilyas1,4, Isabel Dapena1,2, Esther A Groeneveld-van Beek1,4, Gerrit R J Melles5,6,7. 1. Netherlands Institute for Innovative Ocular Surgery, Laan op Zuid 88, 3071 AA, Rotterdam, The Netherlands. 2. Melles Cornea Clinic Rotterdam, Rotterdam, The Netherlands. 3. UAB Callahan Eye Hospital, Birmingham, AL, USA. 4. Amnitrans EyeBank Rotterdam, Rotterdam, The Netherlands. 5. Netherlands Institute for Innovative Ocular Surgery, Laan op Zuid 88, 3071 AA, Rotterdam, The Netherlands. research@niios.com. 6. Melles Cornea Clinic Rotterdam, Rotterdam, The Netherlands. research@niios.com. 7. Amnitrans EyeBank Rotterdam, Rotterdam, The Netherlands. research@niios.com.
Abstract
PURPOSE: The purpose of this study was to evaluate the 5-year clinical results of isolated Bowman layer (BL) transplantation in the treatment of advanced keratoconus. METHODS: In this prospective, single-center, interventional case series at a tertiary referral center, 20 eyes of 17 patients with advanced keratoconus underwent BL transplantation, i.e. an isolated Bowman layer graft was positioned into a manually dissected mid-stromal pocket. Scheimpflug-based corneal tomography measurements, best corrected spectacle and contact lens visual acuities (BSCVA and BCLVA), endothelial cell density, and complications were evaluated up to 5 years after surgery. RESULTS: Measured simulated and maximum keratometry (Kmean and Kmax) values were stable up to 5 years after surgery (P = .310 and P = .195 for 5 years compared to 1 month follow-up, respectively), following an initial decrease from pre- to 1 month postoperatively (P < .001 each). Mean LogMAR BSCVA remained stable (P > .99), after an initial improvement from pre- to 12 months postoperatively (P = .007). Mean BCLVA did not change from preoperative to 5 years postoperatively (P = .219). During all postoperative follow-ups, mean densitometry values were higher than preoperatively (P < .001). A corneal hydrops occurred in one eye at 4.5 years postoperatively; no other postoperative complications were observed. Kaplan-Meier analysis showed an estimated success rate of 84% at 5 years postoperatively. Endothelial cell density remained stable from before to 5 years after surgery (P = .319). CONCLUSIONS: After early postoperative corneal flattening, topographies were stable up to 5 years after BL transplantation, preserving BCLVA and contact lens tolerance, potentially allowing long term postponement of penetrating or deep anterior lamellar keratoplasty.
PURPOSE: The purpose of this study was to evaluate the 5-year clinical results of isolated Bowman layer (BL) transplantation in the treatment of advanced keratoconus. METHODS: In this prospective, single-center, interventional case series at a tertiary referral center, 20 eyes of 17 patients with advanced keratoconus underwent BL transplantation, i.e. an isolated Bowman layer graft was positioned into a manually dissected mid-stromal pocket. Scheimpflug-based corneal tomography measurements, best corrected spectacle and contact lens visual acuities (BSCVA and BCLVA), endothelial cell density, and complications were evaluated up to 5 years after surgery. RESULTS: Measured simulated and maximum keratometry (Kmean and Kmax) values were stable up to 5 years after surgery (P = .310 and P = .195 for 5 years compared to 1 month follow-up, respectively), following an initial decrease from pre- to 1 month postoperatively (P < .001 each). Mean LogMAR BSCVA remained stable (P > .99), after an initial improvement from pre- to 12 months postoperatively (P = .007). Mean BCLVA did not change from preoperative to 5 years postoperatively (P = .219). During all postoperative follow-ups, mean densitometry values were higher than preoperatively (P < .001). A corneal hydrops occurred in one eye at 4.5 years postoperatively; no other postoperative complications were observed. Kaplan-Meier analysis showed an estimated success rate of 84% at 5 years postoperatively. Endothelial cell density remained stable from before to 5 years after surgery (P = .319). CONCLUSIONS: After early postoperative corneal flattening, topographies were stable up to 5 years after BL transplantation, preserving BCLVA and contact lens tolerance, potentially allowing long term postponement of penetrating or deep anterior lamellar keratoplasty.
Authors: Robert P L Wisse; Jonas J W Kuiper; Renze Gans; Saskia Imhof; Timothy R D J Radstake; Allegonda Van der Lelij Journal: Ocul Surf Date: 2015-07-30 Impact factor: 5.033
Authors: Rénuka S Birbal; Korine van Dijk; Jack S Parker; Henny Otten; Maha Belmoukadim; Lisanne Ham; Lamis Baydoun; Isabel Dapena; Gerrit R J Melles Journal: Eye Vis (Lond) Date: 2018-10-11
Authors: Duoduo Wu; Dawn Ka-Ann Lim; Blanche Xiao Hong Lim; Nathan Wong; Farhad Hafezi; Ray Manotosh; Chris Hong Long Lim Journal: Front Pharmacol Date: 2021-07-19 Impact factor: 5.810