{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T07:18:57Z","timestamp":1785568737218,"version":"3.56.0"},"reference-count":50,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Mid-stromal isolated Bowman layer transplantation aims to reduce and stabilize corneal ectasia in patients with advanced, progressive keratoconus. The purpose of this review is to evaluate the effectiveness and safety of this new surgical technique. (2) Methods: Following the PRISMA statement and checklist, we searched Medline, the Cochrane Controlled Trials Register, and Embase and used a broad systematic search strategy according to the Cochrane Collaboration. (3) Results: Eight studies with a total number of 120 eyes of 106 patients met our inclusion criteria. One month after Bowman layer transplantation, patients with keratoconus showed a significant decrease in the measured simulated keratometry (\u22124.74 D [95% CI \u22126.79 to \u22122.69]) and the maximum keratometry (\u22127.41 D [95% CI \u22129.64 to \u22125.19]), which remained significant one year postoperatively (\u22122.91 D [95% CI \u22125.29 to \u22120.53] and \u22125.80 D [\u22128.49 to \u22123.12]). Intra- and postoperative complications were observed in 3% and 9% of the patients, respectively. An estimated success rate of 75% to 85% was achieved by experienced surgeons at 5 to 8 years postoperatively. (4) Conclusions: Bowman layer transplantation may be an effective and safe treatment option in patients with advanced, progressive keratoconus. Additional multicenter prospective interventional studies are needed to confirm these preliminary findings.<\/jats:p>","DOI":"10.3390\/jcm12062402","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T02:36:22Z","timestamp":1679366182000},"page":"2402","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Bowman Layer Transplantation for Treating Keratoconus\u2014Preliminary Findings"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5043-5999","authenticated-orcid":false,"given":"Eline","family":"De Clerck","sequence":"first","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Bravetti","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Kropp","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5025-3856","authenticated-orcid":false,"given":"Horace","family":"Massa","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1987-6232","authenticated-orcid":false,"given":"Bojan","family":"Pajic","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"},{"name":"Eye Clinic ORASIS, Swiss Eye Research Foundation, 5734 Reinach, Switzerland"},{"name":"Faculty of Sciences, Department of Physics, University of Novi Sad, Trg Dositeja Obradovica 4, 21000 Novi Sad, Serbia"},{"name":"Faculty of Medicine of the Military Medical Academy, University of Defense, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Thumann","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5125-8840","authenticated-orcid":false,"given":"Ivo","family":"Guber","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.clae.2010.04.006","article-title":"Keratoconus: A review","volume":"33","author":"Wolffsohn","year":"2010","journal-title":"Cont. 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