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September 1986

Epikeratophakia for KeratoconusThe Nationwide Study

Author Affiliations

Medical Monitors of the Nationwide Epikeratophakia Study.
From the Lions Eye Research Laboratories, LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans (Drs McDonald and Kaufman); the Department of Ophthalmology, University of Nebraska Medical Center, Omaha (Dr Durrie); The Ohio State University College of Medicine, Columbus (Dr Keates); and the Center for Clinical Research in Anterior Segment Surgery, University of Illinois Medical Center, Chicago (Dr Sanders). The other Medical Monitors include James B. Aquavella, MD, Department of Ophthalmology, University of Rochester (NY) Medical Center; John D. Hunkeler, MD, in private practice, Kansas City, Mo; and Keith S. Morgan, MD, LSU Eye Center.

Arch Ophthalmol. 1986;104(9):1294-1300. doi:10.1001/archopht.1986.01050210048024

• 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.