Histological Comparative Analysis of Bowman Layer Grafts Procured Using 3 Different Techniques

Area of Science:

• Ophthalmology
• Histology
• Corneal Transplantation

Background:

• Bowman layer (BL) transplantation is a key procedure in treating corneal diseases.
• Optimizing BL graft procurement is crucial for successful outcomes.
• Histological evaluation is necessary to assess graft purity and thickness.

Purpose of the Study:

• To histologically analyze Bowman layer (BL) grafts obtained using three distinct donor preparation techniques.
• To evaluate the purity and thickness of BL grafts procured for transplantation.

Main Methods:

• Bowman layer (BL) grafts were prepared from 13 human cadaver corneas using three different techniques.
• Grafts were fixed, embedded in paraffin, sectioned, and stained with Hematoxylin and eosin.
• Graft thickness was measured using image-processing software, and graft integrity was assessed.

Main Results:

• All 13 BL grafts contained residual anterior stromal tissue, indicating no technique achieved pure BL.
• BL stripping using Kelman-McPherson and Moorfield forceps resulted in the thinnest mean graft thickness (18.7 μm).
• The Melles lamellar dissector yielded the thickest grafts (279.9 μm), while blunt dissection resulted in 70.2 μm thickness.

Conclusions:

• None of the tested techniques successfully procured pure Bowman layer (BL) grafts without anterior stroma.
• Peripheral scoring and manipulation with Kelman-McPherson and Moorfield forceps produced the thinnest grafts.
• Graft integrity varied, with peripheral tears occurring in up to 100% of samples depending on the technique.