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Manually dissected Bowman's layer lenticule: Novel surgical technique for peripheral ulcerative keratitis and
D S Choudhary1, U Vijay2, J Khan1
1Department of Ophthalmology, SMS Medical College and Attached Hospitals, 302004 Jaipur, Rajasthan, India.
Purpose:
To study Bowman's membrane lenticule as a novel surgical method for treatment in cases of peripheral ulcerative keratitis.
Method:
The study was a hospital-based, single center, prospective interventional study. The study was evaluated in 30 eyes of 30 patients associated with peripheral ulcerative keratitis (PUK). For treatment, Bowman's membrane (BM) lenticule was tucked under the edges of the lesion after formation of recess around gutter. Best-corrected visual acuity (BCVA), mean epithelization time (MET), and corneal contour were measured and compared.
Results:
The study enrolled a total of 30 eyes of 30 patients associated with PUK, out of which 19 were males and 11 females. The mean age of patients in the study was 50.80±10.85years. The mean BCVA changed from 0.311±0.202 decimal units preoperatively to 0.118±0.127 decimal units postoperatively, the MET was 2.30±0.530weeks and the mean corneal thickness changed from a preoperative value of 233.60±115.138 microns to 433.667±46.571 microns postoperatively.
Conclusion:
BM lenticule is a novel surgical technique which is very forcible and staunch method to treat patients suffering from PUK, including perforations. This treatment method adds to the thickness of the cornea reasonably sufficiently, reduces inflammation by acting as barrier between raw surface and inflammatory mediators, promotes nerve growth and reinforces healing process.
Insights
Bowman's membrane (BM) lenticule transplantation is a novel surgical method for treating peripheral ulcerative keratitis (PUK). This technique effectively improves visual acuity and corneal thickness while reducing inflammation and promoting healing.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Regenerative Medicine
Background:
- Peripheral ulcerative keratitis (PUK) is a severe inflammatory condition of the cornea.
- Standard treatments for PUK can be invasive and may not always restore corneal integrity or visual function.
- Novel surgical approaches are needed to effectively manage PUK and its complications.
Purpose of the Study:
- To evaluate Bowman's membrane (BM) lenticule transplantation as a novel surgical treatment for peripheral ulcerative keratitis (PUK).
- To assess the efficacy of BM lenticule in improving visual acuity, corneal thickness, and healing time in PUK patients.
Main Methods:
- A prospective, single-center, interventional study involving 30 eyes of 30 patients with PUK.
- BM lenticule was surgically placed under the edges of the corneal lesion.
- Outcomes measured included best-corrected visual acuity (BCVA), mean epithelization time (MET), and corneal contour.
Main Results:
- The mean BCVA improved significantly from 0.311 preoperatively to 0.118 postoperatively.
- The mean epithelization time (MET) was 2.30 weeks.
- Mean corneal thickness increased from 233.60 microns to 433.667 microns, indicating substantial structural reinforcement.
Conclusions:
- BM lenticule transplantation is a robust and effective surgical technique for treating PUK, including cases with perforation.
- The procedure enhances corneal thickness, reduces inflammation by acting as a barrier, and promotes corneal healing and nerve regeneration.
