Selective Bowman's layer transplantation in the treatment of neurotrophic corneal ulcers

The aim of this paper is to present the surgical technique of selective Bowman's layer transplantation as well as the results of the surgery in patients with trophic corneal ulcers. The methodology of the study included three eyes from three patients with neurotrophic corneal ulcers grafting with corneal Bowman's layer. Pre- and postoperative analyses of the anterior segment of the eye were based on optical coherence tomography and slit-lamp assessment. Postoperatively a gradual corneal stroma restoration and fast corneal epithelialization were noticed. Based on our observations, the stiff and firm structure of Bowman's layer is supposed to strengthen the corneal surface and maintain its shape. It acts also as an antipathogen and antitoxin corneal barrier. Application of this acellular corneal layer transplantation to cover trophic corneal ulcers is an interesting, modern and crucial method of neurotrophic keratitis treatment.