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

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  • 1*Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, MD.

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|April 18, 2023
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Summary

Histological analysis of Bowman layer (BL) grafts revealed that no technique yielded pure BL. Peripheral scoring with forceps resulted in the thinnest grafts, though all contained residual stroma.

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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.