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Live-epikeratophakia for keratoconus

J H Krumeich1, J Daniel, A Knülle

  • 1Eye Department, Martin-Luther-Hospital Bochum, Germany.

Journal of Cataract and Refractive Surgery
|May 19, 1998
PubMed
Summary

Refractive live-epikeratophakia (L-EPI) is a safe surgical option for early keratoconus, potentially halting disease progression. This minimally invasive technique offers a viable alternative to traditional treatments.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Refractive Surgery

Background:

  • Keratoconus is a progressive ectatic corneal disorder.
  • Early-stage keratoconus (Stage I-II) presents challenges for refractive correction and disease management.
  • Traditional treatments may be invasive or not address refractive error effectively.

Purpose of the Study:

  • To evaluate the clinical feasibility of refractive live-epikeratophakia (L-EPI) for early keratoconus.
  • To assess L-EPI's ability to cap the ectatic cornea and correct refractive errors.
  • To determine the safety and efficacy of L-EPI in managing early keratoconus.

Main Methods:

  • Twenty-seven patients with Stage I-II keratoconus underwent L-EPI.
  • Donor lenticules were prepared and shaped using refractive dies for emmetropia.
  • Lenticules were sutured into a trephinated corneal bed using a specific technique.

Main Results:

  • Re-epithelialization occurred within 4-6 days.
  • Lenticule stability was maintained in most cases over a 10-year follow-up, with no signs of keratoconus progression.
  • Best spectacle-corrected visual acuity improved significantly postoperatively, with 13 eyes achieving or exceeding preoperative levels by 1 month.

Conclusions:

  • Refractive live-epikeratophakia is a safe, minimally invasive extraocular procedure for early keratoconus (Stage I-II).
  • The procedure may arrest keratoconus progression.
  • L-EPI is a reversible procedure, allowing for subsequent penetrating keratoplasty if needed.

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