Two year follow‐up of epikeratophakia for keratoconus

Abstract Fifty‐three epikeratophakia procedures were peformed on 50 patients with keratocouns. Of the 53 surgical procedures and 3 re‐operations performed, 88.7% were anatomically successful. Three falled grafts were replaced successfully; in all, 94% of the patients had anatomically successful grafts. Forty one patients have been followed for more than 12 months and in 10 patients the follow‐up extended to over 2 years. There was a significant improvement in the mean preoperative to postoperative uncorrected visual acuity. At 1 and 2 years postoperatively, the best corrected visual acuities all returned to within one line of their preoperative best corrected acuity; in more than 80%, acuities were 20/40 or better. The mean flattening by keratometry readings was 8.5 diopters (D) and the mean decrease in myopia in terms of spherical aquivalent was 4.0 D. One case report is presented to show in detail the topographical changes induced by epikeratophakia in keratoconus. A group of patients with advanced keratoconus who did not meet the entry criteria of the nationwide study (USA) also underwent epikeratophakia. The broadening of the indications to more advanced cases of keratoconus was shown to result in less satisfactory visual outcome and more complications. 1990 Institution Acta Ophthalmologica Scandinavica