Keratometric and refractive results of pediatric epikeratophakia

R. C. Arffa, T. L. Marvelli and K. S. Morgan

Keratometric and refractive results of pediatric epikeratophakia showed that patients under 1 year of age had steeper corneas preoperatively and required more correction, as estimated by the Sanders-Retzlaff-Kraff regression formula. The average spherical equivalent of refractive error six months postoperatively was +6.92 +/- 4.67 diopters in patients under 1 year, and -0.72 +/- 4.22 D in patients over 1 year. Three of 14 younger patients and 35 of 54 older patients were within 3 D of emmetropia. Since March 1982, significant undercorrection has occurred only in patients 6 months old or younger. Younger children achieved an average of 46% of the predicted change in corneal curvature, while older children achieved 85%. Also, the Sanders-Retzlaff-Kraff formula may be inaccurate in estimating powers for younger children. Therefore, we recommend at this time that epikeratophakia be used as a secondary procedure in neonates with congenital cataracts.