Abstract
BackgroundAssessment of the optical outcome and adverse events in post-epikeratopathic eyes after removal of the epikeratoplasty lenticule (EKPL).MethodsThis was a retrospective case-series study of patients who underwent EKPL removal between 2002 and 2020. Ten eyes were included in the analysis. We compared the clinical characteristics of the patients before surgery, 6 months after surgery, before lenticular removal, and after removal, and reported optical or ocular surface complications.ResultsWe removed EKPL due to the lenticular opacity in five eyes (50%), intraocular lens (IOL) insertion (n = 4, 40%) after cataract surgery (n = 3) or in aphakic eyes (n = 1), and lenticule-induced irregular astigmatism in one eye (10%). After EKPL removal, the mean refractive power of the cornea (Km) revealed a tendency to increase. Out of nine cases, six cases showed corneal steepening and three cases revealed corneal flattening. When the keratometric readings of pre-epikeratoplasty and post-lenticular removal were compared within the same case, the average difference was 5.1 D ± 4.0 (n = 8). Complications were observed in 3 of 10 cases (excessive corneal flatness, ectatic change, and abnormal epithelial cell ingrowth) after removal.ConclusionsThe surgeon should expect the corneal refractive power to steepen or flatten in some cases with abnormal astigmatism and irregularity. Epikeratophakic eyes may exhibit serious ectatic changes, and abnormal epithelial cell ingrowth after removal of epikeratophakic lenticules.
Highlights
Assessment of the optical outcome and adverse events in post-epikeratopathic eyes after removal of the epikeratoplasty lenticule (EKPL)
We removed epikeratophakic lenticules (EKPL) due to lenticular opacity in five eyes (50%), intraocular lens (IOL) insertion (n = 4, 40%) after cataract surgery (n = 3), or in aphakic eyes (n = 1), and lenticule-induced irregular astigmatism in one eye (10%)
Opacity was observed in five cases, irregular astigmatism was revealed in one case, and severe myopic shift was present in three cases
Summary
Assessment of the optical outcome and adverse events in post-epikeratopathic eyes after removal of the epikeratoplasty lenticule (EKPL). Epikeratophakia (EKP) was first described about 40 years ago [1]. Since it has been used as a refractive surgical procedure to correct the large refractive errors associated with aphakia, high myopia, and keratoconus [1,2,3,4,5,6]. Patients who had received EKP in the past have revisited with ocular disease. Among these patients, lenticular removal is required for cataract surgery or lenticular opacity. There have been studies that published long-term results of EKP [8], but there have been few studies about the clinical outcomes after lenticular removal. To inform the patients what happens after removal of
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