Trephination with vacuum trephine in undercorrection of myopic epikeratoplasty

For the treatment of undercorrection after myopic epikeratoplasty, early suture removal, scar revision, retrephination, replacement of lenticule and, recently, excimer laser photorefractive keratoplasty have been employed. We performed trephination with Hessburg-Barron vacuum trephine on 11 eyes of 11 patients whose post-epikeratoplasty myopic power was over -4.00 diopters for 3 consecutive months. Patients were followed up on post-trephination 1 month, 3 months and 6 months. The mean duration from epikeratoplasty to trephination was 14.27 months, the mean pre-trephination spherical equivalent was -8.50 D and the mean keratometric reading was 40.87 D. The mean reduction of spherical equivalent was -4.07, -5.99, -8.02 D at post-trephination 1, 3, 6 months, respectively. The mean keratometric reading was 37.60 diopters at 1 month and 41.53 diopters at 6 months. At 1 and 3 months, there were significant reductions of myopic power in refraction and keratometry (p < 0.01), but, at 6 months, regression to pre-trephination levels took place (p > 0.05). There was no change of uncorrected and best corrected visual acuity between baseline and post-trephination 6 months.