Bowman Layer Transplantation—A Review

Abstract

Bowman layer (BL) transplantation has been described for various indications, including the treatment of postrefractive corneal haze, postherpetic scarring, and keratoconus. The unique properties of the BL explain its versatility. Robust, thin, and acellular, transplanted BL inhibits stromal scarring, flattens ectatic corneas, and poses minimal risk of immune reaction. This article reviews the history of BL transplantation and recent developments, and anticipated next steps for the procedure.

Advanced surgeries, medicines and materials for corneal regeneration

“…All corneal layers seem to be affected by the disease with some controversy regarding the endothelium. One of the most typical histopathological signs of the disease is breaks in BL 31,32 . Based on that, BL transplantation has been tried with favourable outcomes since 2014 to re-establish strong structural support in patients with advanced keratoconus that cannot tolerate contact lenses.…”

Corneal Donation: Current Guidelines and Future Direction

“…Damage to Bowman's Layer can also indicate damage to the stroma as the BL is formed early in development and cannot be repaired later. 34 DMEK transplantations present another set of criteria due to the intricacy of the procedure. Donor tissue selection is thus crucial for the DMEK process.…”

“… 33 The primary evaluation criteria for BL grafts include tearing of the BL and thickness of graft. 34 A thick BL graft may contain additional stromal tissue, leading to poor quality of vision following transplantation. Tearing of the BL leads to damage of tissue, thus rendering it non-viable.…”

“…Damage to Bowman’s Layer can also indicate damage to the stroma as the BL is formed early in development and cannot be repaired later. 34 …”

Diseño, desarrollo y validación de un cuestionario para evaluar el compromiso visual y emocional en pacientes con queratocono

“…Algunos autores lo han considerado como una técnica potencialmente prometedora aunque aún hace falta más evidencia científica para demostrar sus resultados. [95,96]…”