Intraepikeratophakia: surgical technique and postoperative visual recovery

Intraepikeratophakia is a refractive surgical technique useful in the treatment of aphakia, myopia, and keratoconus. It is based on the epikeratophakia technique developed by Kaufman and Werblin and involves the grafting of corneal epithelium onto a donor lenticule. Previous findings noted that grafting of the corneal epithelium results in rapid surgical recovery and increased patient comfort. It also lowers the likelihood of surgical failure (loss of the donor lenticule). The postoperative visual acuity of 42 consecutive patients who underwent either intraepikeratophakia or epikeratophakia is described. Patients who underwent intraepikeratophakia had a significantly faster rate of visual recovery than epikeratophakia patients. Of all patients 88% had a visual acuity of within two Snellen lines of best-corrected preoperative visual acuity by six months postoperatively. Of these 20 of 23 (87%) intraepikeratophakia patients and 17 of 19 (89%) epikeratophakia patients obtained this level of visual recovery. Special instrumentation and a modification of the surgical technique involving the use of tissue culture techniques is presented. Patients undergoing this modification of intraepikeratophakia had the fastest visual recovery. Continued improvements in the methodology of intraepikeratophakia are expected.