In Vivo Confocal Microscopy Findings in Bowman Layer Transplantation.

PURPOSE

To report the in vivo confocal microscopy (IVCM) findings of a case who underwent femtosecond laser-assisted Bowman layer transplantation (BLT).

METHODS

This is a case report.

RESULTS

In a 25-year-old man with previous diagnosis of keratoconus in whom a BLT was performed using the femtosecond laser-assisted technique, IVCM (Confoscan 4; Fortune Technologies, Vigonza, Italy) was performed 3 months after surgery, obtaining a sequence of 4 digitalized images of the total thickness of the cornea, from the epithelium to the endothelium, and then backward. The images were analyzed with the Navis v. 3.5.0. system (NIDEK, Multi-Instrument Diagnostic System, Japan). In the anterior stroma, before arriving to the graft interphase, activated keratocytes could be observed with higher reflectivity. In this first image of the anterior interphase, a homogenous hyporreflective image could be observed. In the interior of the graft, no keratocytes were found and some hyperreflective particles were present. In addition to the anterior, the posterior interphase presented bright particles.

CONCLUSIONS

This is the first report that documents a BLT using IVCM.