Trephination was performed for the purpose of correction of undercorrection after epikeratoplasty. We classified two group-Delayed regression group represented regression toward myopia more than 3D again after spherical equivalant become stable. Undercorrection group represented remained myopia after epikeratoplasty. Thirteen trephinations were performed on eleven eyes. Mean follow-up period was 22.4 weeks. In skiascopy, totally 1.15D myopia was decreased. In delayed regression group myopia was increased 0.5D, while in undercorrection group, myopia was dereased 3.5D, The results of three eyes in eleven eyse were satisfactory. Those 3 cases were from undercorrection group. The results suggest that trephination might be effective method for correction of remained myopia in undercorrection group.
Epikeratophakia* ; Follow-Up Studies ; Myopia ; Retinoscopy ; Trephining*

To investigate the effect of disposable contact lenses (CL) on the corneal epithelial healing, a prospective study of 30 myopic epikeratoplasties which were divided into 3 groups according to the method for promoting the corneal epithelial healing was conducted. The groups are consisted of 10 eyes with pressure patch, 10 eyes with Acuvue(R) disposable CL and 10 eyes with SeeQuence(R) disposable CL. Corneal epithelial healing was completed in the pressure patch, Acuvue(R) CL and SeeQuence(R) CL group at 3.4, 3.5 and 3.4 postoperative days, respectively. Corneal epithelial healing rate during postoperative 1, 2 and 3 days are 0.33, O.78, and O.44mm2/hour in pressure patch group, O.24, O.92 and O.37mm2/hour in Acuvue(R) CL group, and O.30, O.79 and O.38mm2/hour in SeeQuence(R) CL group respectively. From the above results, it is concluded that there was no statistically significant difference of the corneal epithelial healing time and rate between the pressure patching and disposable bandage CL wearing after myopic epikeratoplasty.
Bandages* ; Contact Lenses* ; Epikeratophakia* ; Prospective Studies

Epikeratophakia is a newly developed refractive corneal surgery for the correction of aphakic vision. Two aphakic patients have received hyperopic epikeratophakia grafts. Three months postoperatively, two patients had visual acuities of 0.6 without spectacle overcorrection. Epikeratophakia appears to be effective for the correction of adult aphakia.
Adult* ; Aphakia* ; Epikeratophakia* ; Humans ; Transplants ; Visual Acuity

We have performed epikeratoplasty to correct the visual acuity in high myopia who are more than -8.0D and intolerant to the wearing of contract lens, and for the aphakic eyes. It has been also applied to supress the progression of keratoconus. Of 118 eyes performed from january 1989 to july 1992, a total of 90 eyes which could be followed up were subject to the review, including 66 high myopic eyes, 18 keratoconus, and 6 aphakic eyes. In myopic patients, uncorrected visual acuity was stable from a proeperative mean of 0.04 to 0.58 at 4 months. Spherical equivalent was stable from a preoperative mean of -13.99 to -2.01 at 4 months. In keratoconus patients with mean 10.1 months follow-tp, uncorrected visual acuity was changed from 0.05 to 0.33 Corrected viaual acuity was changed from 0.15 to 0.60, keratometry reading was changed from 55.87D to 45.92D. Of 6 aphakic eyes, spherical equivalent of 3 pediatric: aphakic eyes under the age of 3 was changed from +15.0D to +3.41, for the other 3 adult aphakic eyes, spherical equivalent was changed from +9.5D to +1.83D and uncorrected visual acuity was changed from 0.03 to 0.32. Epikeratoplasty is effective surgery applicable to the correction of myopia more than -8.0D, keratoconus, and aphakia.
Adult ; Aphakia* ; Epikeratophakia* ; Humans ; Keratoconus* ; Myopia* ; Visual Acuity

After the first description of epikeratoplasty for the correction of aphakia by Kaufman in 1980, the application of epikeratoplasty has been extended further to keratoconus and high myopia. Six epikeratoplasty for 5 eyes of high myopia and 1 eye of keratoconus were performed and followed upto average 4.9 months. All cases improved their uncorrected visual acuity and the preoperative best corrected visual acuity improved or had no change postoperatively except one case on the last visit. In the cases of high myopia, the mean preoperative spherical equivalent of -19.4D was corrected to average -0.23D with the range of -1.75D to +2.5D postoperatively. In the case of keratoconus, there was the mean decrease in 12.0D of myopia in terms of spherical equivalent and the cornea was flattened by over 8D in keratometry readings.
Aphakia ; Cornea ; Epikeratophakia* ; Keratoconus ; Myopia ; Reading ; Visual Acuity

After the first description of epikeratoplasty for the correction of aphakia, it has been widely used in high myopia and keratoconus for improvement of visual acuity. Seven epikeratoplasties were performed on five high myopia and two keratoconus patients showing intolerance to eye-glasses and contact lens, with the mean follow-up period of 9.7 months. In high myopia, mean spherical equivalent decreased from -15.90D to -2.05D postoperatively. In keratoconus, mean keratometric value decreased more than 4.94D postoperatively and the progression of disease stopped. All patients showed an imporvement in thei uncorrected visual acuity and best corrected visual acuity. In all cases, reepithelialization completed in 4-23 days (mean 14 days).
Aphakia ; Epikeratophakia* ; Follow-Up Studies ; Humans ; Keratoconus ; Myopia ; Visual Acuity

Epikeratophakia was first described in 1980 by Kaufman, the correction of aphakia in adults. Since then, epikeratoplasty has been emploed for the correction of high myopia, keratoconus and most often. We have operated on high myopic eye, for which spectacles or contact lenses were no good enogh to correct myopia. 32 epikeratoplasty for 26 patients of high myopia were operated on and followed up to reveal the effect of the epikeratoplasty. The cases with 6 months or more followed up are reviewed. The cases reviewed are followed up at least 6 month or more. All cases improved their uncorrected visual acuity 20/40 or better. The mean keratometric reduction after surgery was 11.2D. Mean preoperative spherical equivalent of -12.8D was corrected to average -0.4D postoperatively. This study has revealed that epikeratoplasty has a couple of unique advantatges; a wide range of the correction of visual acuity and no postoperative complications. And these advantages were us to make epikeratoplasty a first choice method for the correction of high myopia.
Adult ; Aphakia ; Contact Lenses ; Epikeratophakia* ; Eyeglasses ; Humans ; Keratoconus ; Myopia* ; Postoperative Complications ; Visual Acuity

It has been widely accepted due to its simplicity, safety and effectiveness to correct high myopia by epikeratoplasty. We evaluated clinical results of 23 cases of myopic epikeratoplasty over one year follow up. The uncorrected visual acuity improved in all cases and corrected visual acuity improved in 20 cases (91%). But, in 5 cases (22%), we experienced progressive loss of lenticular power more than 4 diopter of emmetropia and their clinical courses were also reviewed Two cases were both eyes of the same patient. The loss of lenticular power appeared as early in 5th week and even in 6th month postoperatively. We could not find any differences between this grolp of power loss and that of remained well corrected within 4 diopter of emmetropia, except preoperative spherical equivalent (-19 diopter vs -15 diopter), period of reepithelization (8.2 days vs 5.9 days), and mean age (25.8 years vs 31.1 years). But, only the difference of mean age was statistically significant (p<0.05). In addition, the surgical techniques the process of manufacturing tissue lenticule, and postoperative care might be document2d as possible factors.
Emmetropia ; Epikeratophakia* ; Follow-Up Studies ; Humans ; Myopia ; Postoperative Care ; Visual Acuity

In order to compare the clinical results of Epikeratoplasty (EPK) with Laser in situ keratomileusis(LASIK) to be corrected of high myopia above -9 diopters, the effect of the procedure on 74 patients following EKP and 63 patients following LASIK who were followed up at least 1 year were analyzed retrospectively. Postoperative mean uncorrected visual acuity was reached 0.56 until 3 month in EKP group and 0.53 until 1 month in LASIK group. LASIK group recovered and stabilized more rapidly than EKP guoup(p<0.01). Also LASIK group had more rapid recovery in keratometryp(p<0.01) and mean refractive error than EKP group(p<0.01). But there was no significant difference between two groups in uncorrected visual acuity(p=0.62), keratometry(p=0.41) and mean refractive error(p=0.32) at postoperative 1 year. LASIK seems to have more rapid and effective visual recovery than EKP for high myopia treatment.
Epikeratophakia* ; Humans ; Keratomileusis, Laser In Situ ; Myopia* ; Refractive Errors ; Retrospective Studies ; Visual Acuity

PURPOSE: To report a case of cataract surgery in an epikeratophakia patient. CASE SUMMARY: A 59-year-old female with a history of epikeratophakic surgery 20 years ago complained of decreased visual acuity of both eyes for several months. She had nucleosclerotic and posterior subcapsular types of cataracts. Phacoemulsification and posterior capsule intraocular lens implantation were performed in both eyes. During surgery, corneal edema was especially prominent at the cornea with epikeratophakic lenticules in both eyes. In the left eye, severe corneal edema after one day of surgery was observed; however, after one week, corneal edema had subsided and visual acuity of both eyes had improved. CONCLUSIONS: When it necessary that cataract surgery is performed in patients with epikeratophakic lenticules, it is important to anticipate the corneal edema intraoperatively and postoperatively. Moreover, the surgeon should consider the acute calculation of the target refraction of intraocular lens in an epikeratophakia patient.
Cataract* ; Cornea ; Corneal Edema ; Epikeratophakia* ; Female ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Middle Aged ; Phacoemulsification ; Visual Acuity