A comparison of penetrating keratoplasty to epikeratoplasty in the surgical management of keratoconus.
Of 40 patients intolerant to contact lenses, 47 eyes with keratoconus were surgically corrected with either epikeratoplasty (N = 31) or penetrating keratoplasty (N = 16). The percentage of eyes in both groups that had visual acuity of 20/40 or better with contact lenses at one year were equal (14 of 15 eyes [93.3%] in the penetrating keratoplasty group; 27 of 29 eyes [93.1%] in the epikeratoplasty group); however, the penetrating keratoplasty procedure resulted in a higher percentage of eyes that had visual acuity of 20/20 than the epikeratoplasty group (11 of 15 eyes [73%] compared with seven of 29 eyes [24.1%], respectively). Both procedures resulted in significant corneal flattening, with the penetrating keratoplasty group producing an average of 3 diopters more keratometric reduction than the epikeratoplasty group one year postoperatively. Although no irreversible graft failures occurred, five of 16 eyes (31%) in the penetrating keratoplasty group had graft reactions. No serious complications were noted in the eyes of the epikeratoplasty group. Both procedures were effective in the surgical management of keratoconus.
Goosey
J D
JD
Department of Ophthalmology, University of Texas Medical School, Houston.
Prager
T C
TC
Goosey
C B
CB
Bird
E F
EF
Sanderson
J C
JC
D000293:Adolescent; D000328:Adult; D003261:Contact Lenses; D003315:Cornea / Q000473:pathology; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006087:Graft vs Host Reaction; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D008297:Male; D011184:Postoperative Period; D014792:Visual Acuity