title: A method of surgical correction of myopia by fashioning a new optically active epithelial surface: keratoepitheliomileusis.
abstract: A new form of refractive keratoplasty for the correction of myopia was developed using a new approach to the problem. The midperipheral annular area of the recipient cornea was deepithelialized, and Bowman's layer was removed using a special bore coated with diamond crumbs. A cryolathed annular graft was placed on this prepared midperipheral area of the recipient cornea concentrically with its center. As a result of subsequent reepithelialization inside the transplanted ring, a regular optically active surface was formed. The refractive effect gradually appeared eight to ten weeks after surgery This new optically active surface acted as a lens, consisting of epithelial cells on top of the host cornea. The method required neither cutting of the stroma nor any manipulation in the optical zone of the cornea. A new term "keratoepitheliomileusis" was coined for this new procedure. Eleven patients (12 eyes) with high myopia ranging from 7.5 to 22.0D underwent keratoepitheliomileusis. The refractive and visual results found after four to 16 months of follow-up are presented. Emmetropic refraction occurred in three patients. In the other nine eyes, the deviation from emmetropia ranged from 0.75 to 2.5D. In all patients, uncorrected visual acuity was improved considerably (up to 0.3 to 1.OD) without loss in their best-corrected vision.
authors.affiliation: State Institute of Ophthalmology, Moscow, Russia.
authors.forename: M M
authors.initials: MM
authors.lastname: Krasnov
authors.forename: V R
authors.initials: VR
authors.lastname: Mamikonian
mesh_terms: D000328:Adult; D003315:Cornea / Q000502:physiology; D003319:Corneal Stroma / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D004848:Epithelium / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D012029:Refraction, Ocular; D014792:Visual Acuity