This blog post was adapted from a paper published in U.S. Ophthalmic Review, written by senior UAB ophthalmology resident physician Jack Parker, M.D.
At Parker Cornea, we are committed to researching safer treatment options for patients suffering from advanced keratoconus, a disorder that results in a “cone-shaped” cornea that can cause blurred vision, sensitivity to light, distortion of vision and eye irritation, redness and swelling.
What keratoconus patients most need is an operation to arrest progression of the disease, because there is no current treatment that will completely restore the cornea to its normal shape.
For this reason, in 2014 we published the first results of a new operation called “Bowman layer transplantation.” The Bowman layer is the second layer of the cornea, resting next to the epithelium. During a Bowman layer transplant, a donor Bowman layer is surgically transplanted into a pocket created midway in the keratoconic cornea. By supplementing that layer with strong, healthy tissue, the cornea is flattened and progression of keratoconus can be arrested and even partly reversed. This technique has been helpful in halting progression of keratoconus and avoiding the need for more invasive sutured corneal transplant procedures, such as PK and DALK.
This new technique abandons the prior notion that replacing the entire cornea with donor tissue is a necessary course of action.
In our study, we found that after the Bowman layer transplant was preformed, patients’ corneas were significantly flattened, and contact lens wear was preserved or restored.
Benefits to the Bowman layer transplant in comparison to PK and DALK transplants include a decreased chance of rejection, unlikely chance of cataract formation, elimination of sutures, and little need for steroids after surgery.
Further studies will be necessary, but we have already found significant improvements with the results of the Bowman layer transplantation, even in eyes that are ineligible for other methods of transplantation.
For the detailed editorial written by Jack Parker, MD, please read Toward Safer Treatment Options for Advanced Keratoconus.