Bowman layer transplantation another option for advanced keratoconus

Irregular astigmatism and decreased visual acuity secondary to corneal thinning and ectasia associated with keratoconus can deleteriously affect visual quality and hence quality of life in these patients.Keratoconus prevalence varies based on location and race, affecting 57 in 100,000 Caucasian patients and 229 in 100,000 Asian patients. Clinical and surgical options decrease as this condition progresses to advanced stages of keratoconus. Glasses and contact lenses (rigid gas permeable, soft or hybrid) are usually not the best option in advanced keratoconus because the quality of vision is often suboptimal and may not meet the requirements for the patient’s daily activities. Corneal cross-linking and intracorneal ring segment implantation may not be an option in a subset of advanced keratoconus patients with thin corneas. In these cases, anterior lamellar keratoplasty or penetrating keratoplasty may be a surgical choice. PK often becomes the choice in cases with full-thickness corneal scars that are in the central or paracentral regions of the cornea.