Ten-year follow-up of epikeratophakia for the correction of high myopia.
OBJECTIVE
To determine the long-term functional results of epikeratophakia for myopic patients.


METHODS
Retrospective, noncomparative, interventional case series.


METHODS
Twenty-two patients (32 eyes; average age, 43+/-6 years) who underwent epikeratophakia surgery for high myopia. Mean preoperative myopia was -18.74+/-9.16 diopters (D; range, -7 D to -49 D). Follow-up was 12+/-2 years.


METHODS
Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), change in mean keratometry, visual acuity under glare conditions, BCVA versus potential acuity meter reading, and patient satisfaction with the visual outcome.


RESULTS
Mean preoperative UCVA increased from 20/800+/-20/400 (range, counting fingers-20/400) to 20/80+/-20/200 (range, 20/250-20/32) in 24 eyes. Mean preoperative BCVA of 20/32+/-20/64 increased only in five eyes, whereas six eyes had no change and 18 eyes had a more than one line loss of Snellen BCVA. Mean preoperative keratometry reading decreased from 43.67+/-0.90 D (range, 41.0-46.25 D) to 37.40+/-2.92 D (range, 29.43-47.68 D). In the presence of glare, mean BCVA decreased to 20/100+/-20/100 (range, counting fingers-20/32). Potential acuity meter (PAM) readings were significantly (P<0.05) higher than BCVA. Mean PAM reading was 20/25+/-20/100 (range, 20/100-20/16). Seven patients (11 eyes) were extremely satisfied with the operative result more than 10 years after the operation, whereas four patients (four eyes) were not satisfied at all.


CONCLUSIONS
Epikeratophakia for the correction of myopia improved UCVA significantly, but BCVA decreased. The removal of the lenticules in patients who were not satisfied with their visual acuity was uncomplicated, and acceptable vision could be achieved with either contact lenses or intraocular lens implantation.
Department of Ophthalmology, University of Vienna, Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria. s.kaminski@akh-wien.ac.at
Stephan L
SL
Kaminski
Robert
R
Biowski
Didem
D
Koyuncu
Julius R
JR
Lukas
Günther
G
Grabner
D000328:Adult; D000368:Aged; D003315:Cornea / Q000503:physiopathology*; D017391:Epikeratophakia / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology* / Q000601:surgery*; D017060:Patient Satisfaction; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology