Bowman Layer Grafting
The Bowman layer is naturally the stiffest and strongest layer of the cornea. In certain corneal diseases (for example, keratoconus and other forms of ectasia), the Bowman layer becomes damaged, weakening and destabilizing the cornea, resulting in compromised corneal shape and optical transmission.
Recently, however, it has become possible to replace this damaged corneal layer. An isolated “Bowman layer transplant” involves grafting a normal, healthy Bowman layer onto the surface of an eye with pre-existing Bowman layer damage. This transplanted Bowman layer restores the normal strength and clarity of eyes with previous Bowman layer damage.
Who is a candidate for Bowman layer grafting?
The best candidates for Bowman layer grafting are patients with corneal instability caused by prior radial keratotomy (RK), and patients with keratoconus who cannot undergo corneal cross-linking. Other patients may be candidates as well, including those with recurrent corneal erosions caused by epithelial basement membrane dystrophy and central corneal scarring caused by prior herpetic keratitis.
How does Bowman layer graft compare to full-thickness (complete) corneal transplantation?
Until recently, it was not thought possible to replace only the cornea’s Bowman layer, so patients with Bowman layer damage were usually referred for full-thickness (complete) corneal transplantation. Transplanting the entire cornea is a significantly larger and more dangerous operation, with many more risks and a much longer recovery period, compared to Bowman layer grafting alone.
Bowman layer transplantation involves no cuts into your eye, no stitches, and no need for long-term eye drops. In contrast, full-cornea transplantation involves stitches which must remain in the eye for years and a life-time dependence on anti-rejection eyedrops.
Why Parker Cornea for my Bowman Layer grafting procedure?
Drs Jack and John Parker have performed more Bowman layer transplants than any other doctors in the world. They are the authors of many scientific articles and book chapters on the technique, and regularly are called to lecture on the subject internationally.