The surgical management of overcorrection in myopic epikeratophakia

Long-term results of myopic epikeratoplasty

Twenty-three eyes of 20 patients who had had myopic epikeratoplasty were evaluated and the mean 21-month postoperative results (range: 12 to 47 months) tabulated. Average preoperative myopia was -16.7 diopters (D) spherical equivalent (range: -10 to -33 D), and average postoperative refractive correction was 13 D. Of 22 eyes, 17 eyes (77%) were within 4 D of emmetropia. Preoperative visual acuities without correction were between 2/200 and 20/100 (average = 2/40); postoperative acuities were between 2/200 and 20/20 (average = 20/40). Average preoperative best corrected visual acuity was 20/30. Best corrected visual acuities were unchanged or improved in 82% of cases. Re-epithelialization was complete within an average of seven days (range: three to 16 days) postoperatively except in one case in which the lenticule was removed because re-epithelialization did not occur. Five cases showed progressive loss of lenticular power.

Epikeratophakia for aphakia, keratoconus, and myopia

A series of 67 cases of epikeratophakia is presented with an average time from surgery of 12.2 months. For aphakia there was a delay in the recovery of vision, but by nine months 83% of 57 patients achieved an acuity equal to, or within 1 line of, the preoperative value. 57% were corrected to within 3 dioptres of emmetropia, but in the latter part of the series 75% were within this range. Astigmatism and reduced contrast sensitivity, especially in the presence of glare, were important complications. For keratoconus, 86% of seven patients with over two months of follow-up achieved a spectacle corrected acuity of 6/9 or better. One patient had surgery for myopia and obtained the desired refractive correction.