Epikeratophakia for keratoconus. The nationwide study
M. B. McDonald, H. E. Kaufman, D. S. Durrie, R. H. Keates and D. R. Sanders
The nationwide study of epikeratophakia for the treatment of keratoconus
involved 69 surgeons in the United States; they operated on 177 eyes as of
Dec 31, 1985. In this first report, the results from 35 surgeons involving
82 cases with 30 or more days of follow-up after suture removal are
described. In all but two patients, uncorrected visual acuity improved; 17
patients showed improvement of three Snellen lines, and 38 patients showed
improvement of four or more lines. The majority of patients' vision
returned to within one line of their best corrected acuity; in 78% it was
20/40 or better postoperatively. Eight patients needed no postoperative
overrefraction at all. The mean flattening by keratometry readings was 9.36
diopters, and the mean decrease in myopia in terms of spherical equivalent
was 5.26 D. No significant changes in intraocular pressure or endothelial
cell counts were noted. Some advantages of epikeratophakia for keratoconus
over the traditional penetrating keratoplasty include the lack of serious,
vision-threatening complications or permanent vision loss, the reversible
nature of the surgery, and the absence of potential immunogenic rejection
phenomena.
