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First Bowman Layer Transplant for Keratoconus Performed at Southwest Eye Institute

Dr. Ahmed Soliman of the Southwest Eye Institute in El Paso, Texas recently performed the first Bowman layer transplant for keratoconus in the state of Texas, making the Southwest Eye Institute only the second center in the entire United States to offer the groundbreaking procedure, which is a minimally invasive, suture-less alternative to full corneal transplant surgery.

The cornea is the thin, clear, dome-shaped outer layer on the front of the eye. Keratoconus is an eye disorder characterized by progressive thinning and changes in the shape of the cornea, usually causing a cone-shaped bulge to develop. Once this happens, affected individuals typically develop visual problems such as blurry or distorted vision and a sensitivity to light.

Treatments for more advanced keratoconus usually begin with the use of hard contact lenses. However, sometimes the symptoms advance and the contact lenses no longer help, or sometimes patients are not tolerant to wearing contact lenses.

In the most severe cases, affected individuals may require a cornea transplant. Historically, the surgeon would remove a full thickness section of the cornea and replace it with a donor cornea. This surgery requires multiple sutures and the prolonged use of steroid eye drops, which can lead to other eye problems such as glaucoma and cataract formation. Even with that, some patients reject the new cornea.

In the new surgery performed by Dr. Soliman, only a portion of the donor cornea (known as the Bowman layer along with some surrounding tissue) is incorporated into the patient’s own cornea to provide support, flatten the center of the cornea back to a more normal shape, and help prevent further progression of the condition. This surgery is much less invasive, doesn’t require any sutures, and requires just a short term use of steroid eye drops. Since there are no sutures, it saves the patient from multiple visits for suture removal and any suture related complications. The risk of rejection is significantly lower than with traditional corneal transplants.

It should be noted that not every keratoconus patient is a candidate for this procedure and that it is best to diagnose and treat keratoconus early in the course of the disease. Besides Bowman layer transplants, Dr. Soliman and his team at the Southwest Eye Institute offer collagen crosslinking which often stops the progression of the disease, but typically needs to be performed before the corneal changes become too advanced.

“I am excited to bring this new procedure for keratoconus to the El Paso region,” said Dr. Soliman, who trained in cornea surgery at the University of Texas Southwestern Medical Center before joining the team at the Southwest Eye Institute in 2016. “This technique was invented by Dr. Melles in the Netherlands and there is currently only one other center in the United States offering this procedure.”

Dr. Soliman can be reached at the Southwest Eye Institute in El Paso, Texas by phone at (915) 267-2020 or by email For more information about the Southwest Eye Institute, visit

The Southwest Eye Institute is the largest and most comprehensive group of eye specialists in the El Paso, Texas area. For more information, to contact their eye care professionals, or to request an appointment, visit or call (952) 267-2020.

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