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ORIGINAL ARTICLE
Year : 2013  |  Volume : 61  |  Issue : 1  |  Page : 18-22

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


1 Cornea and OSD Services, Dr. R. P. Centre, A.I.I.M.S, New Delhi, India
2 Cornea and Refractive Services, Dr. R. P. Centre, A.I.I.M.S, New Delhi, India

Correspondence Address:
Anita Panda
Head of the Department, Cornea and OSD Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of medical Sciences, Ansari Nagar, New Delhi - 110029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.105049

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Purpose: To report outcomes of epikeratoplasty in keratoconus (KC), utilizing manually-prepared plano donor lenticules in terms of flattening of the cone, reduction in astigmatism and improvement in the visual acuity. Materials and Methods: Patients with KC, having visual acuity <20/200, astigmatism >12 diopters (D) but without corneal opacity underwent epikeratoplasty, using manually prepared plano donor lenticules from fresh or M.K preserved corneas, between 1990 - 2000 and followed for 10 years, were included in this report. Visual acuity slit-lamp-biomicroscopy, keratometry, and refraction were performed at 8 weeks, 12 weeks, and 6 months for all 59 patients. The same were carried out at 1 year, 5 years, and 10 years depending upon the availability of the patient for that period. Results: Of the 59 patients, only 26 were available for follow-up after 10 years. At 3 months, 1 year and 5 years, best corrected visual acuity of (BCVA) ≥20/60 were achieved in 84.7%, 84.4% and 80.3% of eyes, respectively. BCVA was 73% at 10-year follow- up, which was due to the presence of posterior subcapsular cataract (PSC). The average keratometric astigmatism and average flattening in diopters stabilized at the end of 3 months, which remained constant at 1, 5, and 10-year follow-up. The average diopter of myopia was stabilized by 1 year, which was almost same at 10 year. Graft was clear in all but 1 eye at 10 year follow-up. Conclusion: Epikeratoplasty is a useful technique for keratoconic eyes without apical scarring who fail or unable to use contact lenses.


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