Anatomical and functional graft survival, 10 years after epikeratoplasty in keratoconus

Panda, Anita; Gupta, Avantika; Sharma, Namrata; Nindrakrishna, Sasikala; Vajpayee, Rasik B

doi:10.4103/0301-4738.105049

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…To the best of our knowledge, the longest follow-up duration of epikeratophakia for the aphakic eye was 28 years, as reported by Kang et al [4]. Studies by Spitznas et al [5] and Panda et al [6] reported follow-up durations of 7 and 10 years, respectively. Both reports showed good results with stable refraction and improved visual acuity.…”

Section: Discussionmentioning

confidence: 87%

“…Epikeratophakia is a refractive surgical procedure in which corneal lenticule tissue from a donor is sutured into the patient's cornea. This procedure is used to correct aphakic eyes, hyperopia, and keratoconus [1][2][3][4][5][6]. Refractive correction is achieved by transplanting a corneal lamellar disk without corneal endothelium, which helps suppress corneal graft rejection.…”

Section: Introductionmentioning

confidence: 99%

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Epikeratophakia for Keratoconus: A Case Report with 30 Years of Follow-Up

Miyai,

Toyono,

Ishii

et al. 2023

Case Reports in Ophthalmological Medicine

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Background. Epikeratophakia is a refractive surgical procedure used to correct aphakic eyes, hyperopia, and keratoconus and is often performed in children. In this report, we present the long-term effects of epikeratophakia on the progression of keratoconus in a patient who underwent surgery. Case Presentation. The patient was a 17-year-old boy with keratoconus who had difficulty wearing hard contact lenses. As a solution, he underwent right eye epikeratophakia with a plano-powered lenticule. We followed up the patient for 30 years. Although the progression of keratoconus ceased in the operated eye, it continued in the nonoperated left eye and resulted in acute hydrops 9 years and 10 months after surgery. Subsequently, 20 years after the operation, anterior-segment optical coherence tomography was performed, which revealed that the progression of keratoconus had been interrupted in the right eye but had continued in the left eye, as evidenced by the parameters of the average and maximum keratometry and thinnest corneal thickness. Conclusions. Herein, we reported the longest follow-up to date of a case of keratoconus, in which one eye was treated with epikeratophakia. The progression of keratoconus was halted in the treated eye but continued in the nonoperated contralateral eye.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Epikeratophakia for Keratoconus: A Case Report with 30 Years of Follow-Up

Miyai,

Toyono,

Ishii

et al. 2023

Case Reports in Ophthalmological Medicine

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“…However, the subsequent final refractive errors and higher-order aberrations may severely affect the visual outcome, even if the surgery is successful [ 31 ]. Epikeratoplasty seems to stabilize astigmatism in patients with keratoconus, suffering from intolerance of contact lens, irrespective of astigmatism and corneal thickness [ 32 ]. Post-operative complications such as, persistent epithelial defect (PED), severe anterior segment inflammation during early post-operative period, graft melting and interface haze during the intermediate post-operative period, hypoesthesia, peripheral corneal ulcer and posterior sub-capsular cataract during the late post-operative period, have been reported [ 33 - 39 ].…”

Section: Introductionmentioning

confidence: 99%

Contact Lenses for Keratoconus- Current Practice

Moschos¹,

Nitoda²,

Georgoudis³

et al. 2017

Open Ophthal. J.

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Background:Keratoconus is a chronic, bilateral, usuallly asymmetrical, non-inflammatory, ectatic disorder, being characterized by progressive steepening, thinning and apical scarring of the cornea. Initially, the patient is asymptomatic, but the visual acuity gradually decreases, resulting in significant vision loss due to the development of irregular astigmatism, myopia, corneal thinning and scarring. The classic treatment of visual rehabilitation in keratoconus is based on spectacles and contact lenses (CLs).Objective:To summarize the types of CLs used in the treatment of keratoconus. This is literature review of several important published articles focusing on the visual rehabilitation in keratoconus with CLs.Method:Gas permeable (GP) CLs have been found to achieve better best corrected visual acuity than spectacles, eliminating 3rd-order coma root-mean-square (RMS) error, 3rd-order RMS, and higher-order RMS. However, they have implicated in reduction of corneal basal epithelial cell and anterior stromal keratocyte densities. Soft CLs seem to provide greater comfort and lower cost, but the low oxygen permeability (if the lens is not a silicone hydrogel), and the inability to mask moderate to severe irregular astigmatism are the main disadvantages of them. On the other hand, scleral CLs ensure stable platforms, which eliminate high-order aberrations and provide good centration and visual acuity. Their main disadvantages include the difficulties in application and removal of these lenses along with corneal flattening and swelling.Result:The modern hybrid CLs are indicated in cases of poor centration, poor stability or intolerance with GP lenses. Finally, piggyback CL systems effectively ameliorate visual acuity, but they have been related to corneal neovascularization and giant papillary conjunctivitis.Conclusion:CLs seem to rehabilitate visual performance, diminishing the power of the cylinder and the high-order aberrations. The final choice of CLs is based on their special features, the subsequent corneal changes and the patient’s needs.

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“…В литературе описаны преимущества данного метода в сравнении со сквозной кератопластикой (СКП). К ним относят уменьшение операционного риска и иммунологических осложнений, ведущих к отторжению трансплантата [9,10]. Авторы сходятся во мнении о недостатках эпикератопластики, описывая слабо прогнозируемый конечный результат операции, снижение контрастной чувствительности, незначительную степень восстановления остроты зрения по сравнению с таковой при СКП [9,10].…”

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