Acute Hydrops After Bowman Layer Transplantation for Keratoconus May Indicate that Descemet Membrane Rupture Is Secondary to Hydrops

Musayeva, Aytan; Santander-García, Diana; Quilendrino, Ruth; Parker, Jack; Dijk, Korine van; Henrat, Carole; Dapena, Isabel; Binder, Perry S.; Melles, Gerrit R.J.

doi:10.1097/ico.0000000000002920

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…It can be inserted as a corneal stromal ‘inlay,’ where the isolated graft is implanted into manually dissected mid-stromal corneal pockets. However, this method can be challenging for the surgeon, with an increased risk for corneal perforation in thinner corneas [34 ▪ ,35]. In the ‘onlay’ approach, the recipient corneal epithelium is debrided and the donor graft is positioned onto the anterior stroma.…”

Section: Surgical Treatmentsmentioning

confidence: 99%

Indications for keratoplasty in management of corneal ectasia

Choi¹,

Jeng²

2022

Current Opinion in Ophthalmology

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Purpose of reviewThe current review aims to describe recent advancements in treatment of corneal ectasias and its effect on indications for corneal transplantation.Recent findingsThe majority of patients affected by ectatic corneal disease use contact lenses to correct resulting astigmatism. Patients who are intolerant of contact lenses or cannot achieve acceptable vision through conservative measures could consider keratoplasty. However, continuing advancements in both nonsurgical and surgical treatments are either reducing or delaying the need for keratoplasty in patients affected by ectatic corneal disease.SummaryCorneal transplantation has been the mainstay of treatment for patients with advanced ectatic corneal disease. In the past decade, numerous improvements have been occurred to make contact lenses not only more effective for visual correction, but also more comfortable. Although corneal cross-linking is the only proven treatment known to prevent progression of disease, several other therapies show early potential for those in which cross-linking is contraindicated. Patients now have access to a wider range of therapies before considering keratoplasty.

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Section: Surgical Treatmentsmentioning

confidence: 99%

Indications for keratoplasty in management of corneal ectasia

Choi¹,

Jeng²

2022

Current Opinion in Ophthalmology

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“…However, spontaneous resorption of hydrops is reported. Eye rubbing is identified as a risk behavior [ 37 , 38 ].…”

Section: Introductionmentioning

confidence: 99%

Bowman Layer Transplantation for Treating Keratoconus—Preliminary Findings

Clerck

Bravetti

Kropp

et al. 2023

JCM

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(1) Background: Mid-stromal isolated Bowman layer transplantation aims to reduce and stabilize corneal ectasia in patients with advanced, progressive keratoconus. The purpose of this review is to evaluate the effectiveness and safety of this new surgical technique. (2) Methods: Following the PRISMA statement and checklist, we searched Medline, the Cochrane Controlled Trials Register, and Embase and used a broad systematic search strategy according to the Cochrane Collaboration. (3) Results: Eight studies with a total number of 120 eyes of 106 patients met our inclusion criteria. One month after Bowman layer transplantation, patients with keratoconus showed a significant decrease in the measured simulated keratometry (−4.74 D [95% CI −6.79 to −2.69]) and the maximum keratometry (−7.41 D [95% CI −9.64 to −5.19]), which remained significant one year postoperatively (−2.91 D [95% CI −5.29 to −0.53] and −5.80 D [−8.49 to −3.12]). Intra- and postoperative complications were observed in 3% and 9% of the patients, respectively. An estimated success rate of 75% to 85% was achieved by experienced surgeons at 5 to 8 years postoperatively. (4) Conclusions: Bowman layer transplantation may be an effective and safe treatment option in patients with advanced, progressive keratoconus. Additional multicenter prospective interventional studies are needed to confirm these preliminary findings.

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