BLAST (Bowman Layer Anterior Stroma Transplantation): A Case Report of a Novel Technique for Corneal Transplantation in Keratoconus

Objective: To present the outcome of a patient who underwent a novel surgical technique for keratoconus (BLAST - Bowman Layer Anterior Stroma Transplantation) and confirm its efficiency, acceptability, and validity as a future treatment option. Participant: 50-year-old male with severe keratoconus. Methods and Procedure: The patient underwent the BLAST procedure described in this article to treat his condition, with a follow-up at 1 week, 9 months, and 1-year post-op. Results: Measurements include Keratometry Maximal (K Max), Best Corrected Visual Acuity (BCVA), as well as Uncorrected Visual Acuity (UCVA) and pachymetry using the Pentacam at each follow-up. The BCVA showed drastic improvements, from 20/200 with pinhole pre-op to 20/50 post-op with a scleral contact lens. The thinnest pachymetry values also demonstrated a significant increase, going from 410 mm pre-op to 633 mm post-op. Discussion and Conclusion: The BLAST intervention provides a new treatment option that shows marked improvements in all parameters measured in follow-up, with a significant increase in the patient's visual acuity. Post-operative K Max, BCVA, UCVA, and pachymetry all improved in comparison to their pre-operative values, showing that this is a viable and noteworthy future treatment option for patients with moderate-to-severe keratoconus.