title: Epikeratoplasty. The surgical correction of aphakia, myopia, and keratoconus.
abstract: Thirty-five patients have had 39 consecutive epikeratoplasty procedures (12 adult aphakic, 9 pediatric aphakic, 12 myopic, and 6 keratoconic eyes) by the same surgeon, using commercially prepared lenticules. The lenticule remained totally clear in 85% of eyes. Two lenticules were removed due to infection and scarring; four lenticules had minimal scarring and did not require removal. Spectacle-corrected acuity was worse than one line from the preoperative spectacle-corrected acuity in 58% of the adult aphakic eyes; however, 75% were 20/50 or better postoperatively. Fifty percent were within 2 diopters (D) of emmetropia and 92% within 3 D. All pediatric aphakic patients showed an improvement in best-corrected acuity, and 83% of eyes at 6 months were within 2 D of emmetropia; by 1 year a 3.4-D average myopic shift had occurred. Two of the six eyes (33%) using the original myopia technique were within 2 D of emmetropia, whereas five of the six eyes (83%) with the current technique are within this range. Spectacle-corrected acuity in the entire current myopia group has either improved by one or more lines or has remained unchanged. Five of the six keratoconic eyes had 20/40 or better spectacle-corrected and 20/25 contact lens-corrected acuity postoperatively; average corneal flattening was 6 D. Persistent epithelial defect and irregular astigmatism were the principal factors in delay in visual recovery.
authors.affiliation: Division of Ophthalmology, Case Western Reserve University, Cleveland, OH.
authors.forename: J H
authors.initials: JH
authors.lastname: Lass
authors.forename: E G
authors.initials: EG
authors.lastname: Stocker
authors.forename: M E
authors.initials: ME
authors.lastname: Fritz
authors.forename: D M
authors.initials: DM
authors.lastname: Collie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001035:Aphakia / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D016039:Corneal Transplantation; D006801:Humans; D007223:Infant; D007640:Keratoconus / Q000601:surgery*; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications