Long Term Follow-Up of Epikeratophakia in the Pediatric Aphakia

ABSTRACT

We performed 3 cases of epikeratoplasties on two pediatric aphakic patients who were intolerable to contact lenses & spectacles. These epikeratoplasties were performed in accordance with the Kaufman-McDonald Epikeratophakia Method using the commercially available frozen and dried Kerato-Lens (Allergan Medical Optics), the lenticule of which was rehydrated at the time of surgery. The cataract extractions were performed at 3 months after birth on both eyes of the congenital cataract & at 18 months after birth on the traumatic cataract that had developed at 14 months after birth. The epikeratoplasties for the eyes with congenital cataract were performed at 24 months on the right eye and at 16 months after birth on the left eye respectively. The epikeratoplasty for the traumatic cataract eye was performed at 28 months after birth. The 3 grafts have remained successful over the follow-up period of 4 to 6 years. The right eye of congenital cataract case had myopic shift of 3.75D and best corrected visual acuity of 0.2 during 5-year of follow-up period and the other left eye had myopic shift of 4.75 D and best corrected visual acuity of 0.7 during 6-year of follow-up period. The traumatic cataract case had myopic shift of 1.0 D and best corrected visual acuity of 0.05 during 4-year of follow up period. In view of this, it is considered that the epikeratoplasty is of an effective treatment in correcting the refractive error in the pediatirc aphakia patients who intolerable to contact lens and in whom difficulty exists in determining whether an intraocular lens implantation is appropriate or not.