A comparative study of bowman layer transplantation results without and after ultraviolet crosslinking in advanced keratoconus

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Abstract

Aim. A comparative study of Bowman layer transplantation (BLT) after its ultraviolet (UV) crosslinking and BLT without preliminary UV crosslinking in patients with advanced keratoconus (KC) stages III to IV.

Materials and methods. There were 30 patients aged 14 to 37 years with KC III–IV stages. The first group included 15 patients who underwent BLT without prior UV crosslinking. The second group included 15 patients who underwent BLT after UV crosslinking. The criteria for inclusion of patients in the study were: progressive KC, with corneal thinnest point (CTP) without epithelium of 400 μm or less, a maximum keratometric index (Kmax) of 58 D and more, with patient satisfied by his visual acuity in a scleral contact lens (SCL) and refusing keratoplasty.

Results. In comparison with preoperative data in both groups, Kmax decreased by an average 0.6 ± 0.5 D, and CTP increased in the first group by an average of 41.5 ± 16.3 µm, and in the second group by an average of 31,9 ± 9.2 μm. Best corrected visual acuity (BCVA) did not change.

Conclusion. During the follow-up of 26.6 ± 6.2 (from 6 to 36) months, CTP and Kmax indices remained stable in operated patients, which indicates the arrest of KC progression after BLT with crosslinking and without it. The preservation of endothelial cell density and BCVA values indicates the safety of both methods.

About the authors

Oganes G. Oganesyan

Helmholtz National Medical Research Center of Eye Diseases; A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: oftalmolog@mail.ru

PhD; Professor, Eye Diseases Department

Russian Federation, Moscow

Vostan R. Getadaryan

Helmholtz National Medical Research Center of Eye Diseases

Author for correspondence.
Email: vostan11@gmail.com

MD

Russian Federation, Moscow

Pavel V. Makarov

Helmholtz National Medical Research Center of Eye Diseases

Email: makarovpavel61@mail.ru

PhD

Russian Federation, Moscow

Patimat M. Ashikova

Helmholtz National Medical Research Center of Eye Diseases

Email: patiyago@mail.ru

MD

Russian Federation, Moscow

Nataliya Yu. Ignatieva

Lomonosov Moscow State University

Email: n.yu.ignatieva@gmail.com

Dr. Chem. Sci.

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. Isolated Bowman layer: а – intact samples, b – experimental sample after crosslinking

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3. Fig. 2. Differential scanning calorimetry of Bowman layer control (1) and experimental (2) samples

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4. Fig. 3. Isolated Bowman layer in BSS solution

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5. Fig. 4. Postoperative corneal haze in a group 2 patient

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Copyright (c) 2020 Oganesyan O.G., Getadaryan V.R., Makarov P.V., Ashikova P.M., Ignatieva N.Y.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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