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December 7, 1979

Carving corneas for aphakic patients

JAMA. 1979;242(23):2520-2525. doi:10.1001/jama.1979.03300230006005

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New York researchers are encouraged by results of an experimental microsurgical procedure for altering corneal curvature after cataract removal.

Richard C. Troutman, MD, Downstate Medical Center, State University of New York, Brooklyn, told a Research to Prevent Blindness seminar in Los Angeles that he and colleagues have used the refractive keratoplasty procedure with 38 patients since October 1977.

The keratophakia approach (combined with intracapsular cataract extraction) was used in most cases. A slice of donor cornea is removed with a special microkeratome, frozen, and carved on a modified contact lens lathe into a lens 0.2 mm thick. The homograft is inserted between layers of the patient's cornea to change its curvature. In a related keratomileusis approach, a slice of the patient's own cornea is frozen, carved on the lathe, and sutured back onto the remaining cornea to provide a curvature that has been preprogrammed by computer to correct the optical