Epikeratophakia for Aphakia, Myopia and Keratoconus

Abstract

Since 1979, more than 500 epikeratophakia procedures have been performed at LSU, and over the past 3 years more than 1300 cases have been performed and evaluated by 234 surgeons in a nationwide clinical study. Among the aphakic patients, the adults had the longest rehabilitation times. Seventy-five per cent achieved within 3 dioptres (D) of emmetropia, 95% demonstrated improved uncorrected visual acuity, and 78% had postoperative best corrected visual acuity within two lines or better of their preoperative best corrected visual acuity. Among the children, the final surgical success rate was 95%; no paediatric cases required penetrating keratoplasty. Seventy-three per cent of the paediatric patients were within 3 D of emmetropia. The myopic patients demonstrated more rapid visual recovery than the aphakic adults; 97% regained best corrected visual acuity within 2 lines or better of their preoperative best corrected visual acuity. Half of these improved uncorrected visual acuity by six or more Snellen lines, some by as much as 12 lines. In patients with keratoconus, the majority returned to within one line of preoperative best corrected visual acuity of 20/40 or better. Tight suturing of the tissue over the cone induced an average flattening of 9 D and reduced myopia by an average of 5 D.