Anatomical and functional graft survival, 10 years after epikeratoplasty in keratoconus.
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Date
2013-01
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Abstract
Purpose:
To report outcomes of epikeratoplasty in keratoconus (KC), utilizing manually-prepared plano donor lenticules in terms of flattening of the cone, reduction in astigmatism and improvement in the visual acuity.
Materials and Methods:
Patients with KC, having visual acuity <20/200, astigmatism >12 diopters (D) but without corneal opacity underwent epikeratoplasty, using manually prepared plano donor lenticules from fresh or M.K preserved corneas, between 1990 - 2000 and followed for 10 years, were included in this report. Visual acuity slit-lamp-biomicroscopy, keratometry, and refraction were performed at 8 weeks, 12 weeks, and 6 months for all 59 patients. The same were carried out at 1 year, 5 years, and 10 years depending upon the availability of the patient for that period.
Results:
Of the 59 patients, only 26 were available for follow-up after 10 years. At 3 months, 1 year and 5 years, best corrected visual acuity of (BCVA) ≥20/60 were achieved in 84.7%, 84.4% and 80.3% of eyes, respectively. BCVA was 73% at 10-year follow- up, which was due to the presence of posterior subcapsular cataract (PSC). The average keratometric astigmatism and average flattening in diopters stabilized at the end of 3 months, which remained constant at 1, 5, and 10-year follow-up. The average diopter of myopia was stabilized by 1 year, which was almost same at 10 year. Graft was clear in all but 1 eye at 10 year follow-up.
Conclusion:
Epikeratoplasty is a useful technique for keratoconic eyes without apical scarring who fail or unable to use contact lenses.
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Keywords
Astigmatism, epikeratoplasty, keratoconus
Citation
Panda Anita, Gupta Anoop K, Sharma Namrata, Nindrakrishna Sasikala, Vajpayee Rasik. Anatomical and functional graft survival, 10 years after epikeratoplasty in keratoconus. Indian Journal of Ophthalmology. 2013 Jan-Feb; 61(1): 18-22.