Epikeratophakia in Children

Abstract

Epikeratophakia was performed in 61 children for the correction of aphakia after the removal of unilateral congenital or traumatic cataracts; 51 patients (54 grafts) have more than 6 months follow-up. In the first 27 grafts, 8 (30%) failed, but in the last 27 grafts, only 2 (7%) failed, largely due to improved surgical and tissue handling techniques. The average increase in corneal refractive power for the early patients was 12.68 ± 4.63 D with an average overrefraction of +0.45 ± 5.60 D. The last half of the patients showed an average increase of 14.83 ± 4.83 D, with an average overrefraction of -0.00 ± 5.20 D. Visual acuity results in patients with traumatic cataracts have been the most satisfactory, with the majority of patients obtaining useful vision. It also appears that in patients with congenital cataracts, the younger the patient at the time of surgery, the greater the chance for a good visual result. Some improvement in vision has been seen in all of the children with successful grafts, even those beyond the age when amblyopia therapy would be considered to have some potential for therapeutic effect. By attaching the correction permanently on the eye, epikeratophakia facilitates the vigorous occlusion therapy required after cataract extraction in these children.