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Resection of Epikeratophakialenticles and Implantation of Intraocular Lenses
1Bleckmann H., 2Schnoy N., 3Keuch R.,
1Schloßpark-Klinik, Abteilung Augenheilkunde (Berlin)
2Pathologisches Institut, Krankenhaus Spandau (Berlin)
3Schlosspark-Klinik, Augenabteilung (Berlin)
Purpose: Epikeratophakia has been a remarkable method of refractive surgery more than ten years ago. Myopia, hyperopia including aphakia as well as keratokonus and pterygium have been indications for keratolens applications. A typical complication of this method was the formation of an interface between deepithelized Bowmans layer and keratolens.
Methods: In one eye with high myopia and cataract and another aphakic eye of a 50 and a 52 years old female the keratrolens was removed due to increased interface formation. After the epithelium was removed completely in both eyes an extracapsular cataract extraction including IOL implantation and a sclerafixation into the second eye was performed to correct the refractive error.
Results: The cornea of both patients were clear after wearing the lenticles for over fifteen years, the interface formation was not present any more after the removal of the keratolenses. The histology revealed a normal quantity of keratocytes with a typical pattern and structure. The K-values were decreased due to the reopended trepanized corneas comparable to relaxing incisions. This was the reason for a residual refractive error following the implantation of an IOL in one patient.
Conclusions: Removal of keratolenses after epikeratophakia left a clear cornea in both cases. Refractive correction with intraocular lenses is accurate following the healing of the trepan-cuts resulting in stable K-values.