Groeneveld-van Beek Esther A, Parker Jack, Lie Jessica T, Bourgonje Vincent, Ham Lisanne, van Dijk Korine, van der Wees Jacqueline, Melles Gerrit R J
*Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands;†Amnitrans Eyebank, Rotterdam, the Netherlands;‡UAB Callahan Eye Hospital, Birmingham, AL; and§Melles Cornea Clinic, Rotterdam, the Netherlands.
Cornea. 2016 Dec;35(12):1499-1502. doi: 10.1097/ICO.0000000000000905.
To describe and compare 2 preparation techniques for Bowman layer (BL) grafts for use in BL transplantation.
A retrospective evaluation of the 2 methods for preparing BL grafts was performed, that is, BL graft preparation from donor globes not eligible for penetrating keratoplasty or endothelial keratoplasty (technique I, n = 36) and BL graft preparation from previously excised corneoscleral buttons (technique II, n = 36) that could not be used for PK or had been denuded of Descemet membrane and endothelium for Descemet membrane endothelial keratoplasty graft preparation. BL graft preparation difficulties were recorded, and the preparation failure rate was examined and compared between the techniques.
Overall, BL graft preparation was successful in 51 cases (51/72; 70.8%), of which 25 preparations were successful using technique I, and 26 using technique II, representing a success rate of 69.4% (25/36) and 72.2% (26/36) for techniques I and II, respectively. Reasons for discarding a BL graft were tearing of the BL tissue during the preparation (n = 19) and stroma attached to the graft (n = 2).
Isolated BL grafts can be prepared from both whole donor globes and corneoscleral rims with equivalent success. Preparation from corneoscleral rims may offer the advantage that, from one donor cornea, the posterior layers can be used for Descemet membrane endothelial keratoplasty graft preparation and the anterior part for BL graft preparation.
描述并比较用于Bowman层（BL）移植的两种BL移植物制备技术。
对两种制备BL移植物的方法进行回顾性评估，即从不符合穿透性角膜移植术或内皮角膜移植术标准的供体眼球制备BL移植物（技术I，n = 36），以及从先前切除的角膜缘组织制备BL移植物（技术II，n = 36），这些角膜缘组织无法用于穿透性角膜移植术，或已为Descemet膜内皮角膜移植术移植物制备而去除了Descemet膜和内皮。记录BL移植物制备的困难情况，并检查和比较两种技术之间的制备失败率。
总体而言，72例中有51例（51/72；70.8%）成功制备了BL移植物，其中技术I成功制备25例，技术II成功制备26例，技术I和技术II的成功率分别为69.4%（25/36）和72.2%（26/36）。丢弃BL移植物的原因是制备过程中BL组织撕裂（n = 19）和移植物附着有基质（n = 2）。
从完整的供体眼球和角膜缘都可以成功制备孤立的BL移植物。从角膜缘制备可能具有这样的优势，即从一个供体角膜，后层可用于Descemet膜内皮角膜移植术移植物制备，前部可用于BL移植物制备。
