Epikeratophakia (also known as epikeratoplasty and onlay lamellar keratoplasty) is a refractive surgical procedure in which a lamella of a donor

cornea The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical power ...

is transplanted onto the anterior surface of the patient's cornea. A lamellar disc from a donor cornea is placed over the de-epithelialized host cornea and sutured into a prepared groove on the host cornea. Indications include treatment of

keratoconus Keratoconus (KC) is a disorder of the eye that results in progressive thinning of the cornea. This may result in blurry vision, double vision, nearsightedness, irregular astigmatism, and light sensitivity leading to poor quality-of-life. Usu ...

refractive error Refractive error, also known as refraction error, is a problem with focus (optics), focusing light accurately on the retina due to the shape of the human eye, eye and or cornea. The most common types of refractive error are myopia, near-sightedne ...

s like

myopia Near-sightedness, also known as myopia and short-sightedness, is an eye disease where light focuses in front of, instead of on, the retina. As a result, distant objects appear blurry while close objects appear normal. Other symptoms may include ...

and high

hypermetropia Far-sightedness, also known as long-sightedness, hypermetropia, or hyperopia, is a condition of the eye where distant objects are seen clearly but near objects appear blurred. This blurred effect is due to incoming light being focused behind, i ...

including

aphakia Aphakia is the absence of the lens of the eye, due to surgical removal, such as in cataract surgery, a perforating wound or ulcer, or congenital anomaly. It causes a loss of accommodation, high degree of farsightedness (hyperopia), and a deep a ...

, which cannot be corrected with conservative methods. __TOC__

Complications

Common complications of epikeratophakia include delayed post operative visual recovery, reduced best corrected

visual acuity Visual acuity (VA) commonly refers to the clarity of vision, but technically rates an examinee's ability to recognize small details with precision. Visual acuity is dependent on optical and neural factors, i.e. (1) the sharpness of the retinal ...

, prolonged epithelial defects and irregular

astigmatism Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. This results in distorted or blurred vision at any distance. Other symptoms can include eyestrain, headaches, and trouble driving at nig ...

History

In 1949, José Barraquer introduced refractive procedure of inclusion of a lenticule within the corneal stromal layer. In 1980s, based on Barraquer's procedure, Werblin, Kaufman and Klyce at the LSU Eye Center introduced epikeratophakia.

References

Eye surgery {{Surgery-stub