Epikeratophakia -- the surgical correction of aphakia. Update 1981

Epikeratophakia grafts used to rehabilitate vision in adult monocular aphakic patients intolerate of contact lens correction or not candidates for IOLs were studied prospectively. Thirty-two patients who entered this study between its inception in February 1980 through February 1981 were followed for at least eight months. Patients with normal visual potential before surgery had average visual acuities with spectacle overcorrection of 20/50 at four months, 20/40 at eight months, and 20/30 at one year. Few long-term complications were seen. Empirical modification of the lathing process has decreased the undercorrection from the 5.5 diopters seen in the early patients to the 1.0 diopter seen in the more recent patients. Problems with predictability are related to the behavior of preserved corneal tissue during the lathing and the healing of these lamellar grafts. This procedure is intended for aphakic patients of whom IOL and contact lens correction is not possible.

A prospective study of the use of hyperopic epikeratophakia grafts for the correction of aphakia in adults

The results of a prospective clinical study of hyperopic epikeratophakia grafts for the visual rehabilitation of aphakic patients are presented. Visual acuity data are given for 21 aphakic patients who have been followed for up to six months postoperatively. With spectacle overrefraction, on the average, patients were within three lines of their preoperative potential vision at three months postoperative and within two lines at six months postoperative. Three months postoperatively, two patients achieved visual acuities of 20/20, and 57% had 20/40 or better with spectacle overcorrection. Six months postoperatively, three patients achieved best-corrected visual acuities of 20/20, and 80% had best-corrected visual acuities of 20/40 or better.

Lactate dehydrogenase levels and isoenzyme patterns in the serum and aqueous humor of adult cataract patients

Serum and aqueous humor lactate dehydrogenase (LDH) levels were assayed in 46 patients with senile cataracts at the time of cataract extraction. The mean aqueous level was 37 IU/liter and the mean serum level 152 IU/liter. In each case, the serum LDH level was higher than the corresponding aqueous LDH. The LDH isoenzyme levels were also determined; LDH 4 and LDH 5 were elevated in cataract aqueous samples, while the serum isoenzymes were normal. The LDH studies of normal and diseased globes must be rigorously standardized to avoid artificially high or low levels.