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Manual Bowman-stroma onlay transplant for the treatment of symptoms post-radial keratotomy: proof of concept and preliminary results

Year: 2025
Type: article
Study design: Case Report
Abstract: AIM: To describe the technique and the outcomes of manual Bowman layer and stroma transplant-onlay (BLST-o) for 2 cases of radial keratotomy (RK). METHODS: Two patients with visual fluctuations and corneal irregularity due to RK were offered manual BLST-o as an alternative to penetrating keratoplasty (PKP). Visual acuity, refraction, corneal topography, corneal aberrometry, and corneal optical coherence tomography (OCT) pre- and postoperative were analyzed. Histology was obtained for 1 case. RESULTS: Both patients had corneal anatomical and morphological improvement, with elimination of the visual fluctuations. In one case, a subsequent excimer laser treatment improved corneal shape further, thus improving vision. The other case, whereas initially improved, developed epithelial ingrowth following suture removal. The latter was explanted and had a xenogeneic implant. The explanted sample was sent for histology, showing a viable graft of Bowman layer and anterior stroma. CONCLUSION: Manual BLST-o is a potential option for the management of symptoms post RK. These grafts may facilitate subsequent treatments such as laser corrections, and may not preclude from other interventions after explantation.
Authors: Abdo Karim Tourkmani, Hao Zhang, Vissum Miranza, Alicante 03016, Spain, Jorge L. Alio, Universidad Miguel Hernandez, Elche 03202, Spain; Vissum Miranza, Alicante 03016, Spain
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $1,800
OpenAlex ID: W4417412132
FWCI: 1.09
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Cited by: 2
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