Greenbaum Aaron, Kaiserman Igor, Avni Isaac
Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Cornea. 2007 Dec;26(10):1210-2. doi: 10.1097/ICO.0b013e318154acdd.
To assess the long-term reversibility of epikeratophakia.
Three human epikeratophakia lenticules (from 3 patients) were removed 7-14 years after refractive keratoplasty for aphakia (n = 1) and myopia (n = 2). Reasons for removal were irregular astigmatism (n = 1), opacities in the graft and host cornea, and progressive myopia (n = 2). After removal, 2 patients underwent cataract extraction and 1 underwent secondary implantation of AC-IOL. Visual acuity, refraction, keratometry, and corneal topography were assessed before and after removal of the lenticule, as well as after the cataract and IOL implantation, and were compared with the initial visual acuity and corneal curvature before epikeratoplasty.
After removal of the lenticule, the 3 patients regained the initial curvature of the cornea (pre-epikeratoplasty), and remained stable during 6 months of follow-up. Initial best-corrected visual acuity and refraction before epikeratoplasty were restored after removal of the epikeratoplasty lenticule in the aphakic patient. Original best-corrected visual acuity was restored in the 2 myopic cataract patients after cataract extraction and IOL implantation.
In a small care series, epikeratophakia was found to be a reversible procedure even after 7-14 years.
评估表层角膜镜片术的长期可逆性。
在屈光性角膜移植术后7 - 14年，取出3枚人表层角膜镜片（来自3例患者），其中1例为无晶状体眼（因无晶状体而行屈光性角膜移植），2例为近视患者。取出的原因包括不规则散光（1例）、移植片和宿主角膜混浊以及进行性近视（2例）。取出后，2例患者接受了白内障摘除术，1例接受了前房型人工晶状体二期植入术。在取出表层角膜镜片前后、白内障和人工晶状体植入术后，评估视力、屈光、角膜曲率测量和角膜地形图，并与表层角膜镜片术之前的初始视力和角膜曲率进行比较。
取出表层角膜镜片后，3例患者恢复了角膜的初始曲率（表层角膜镜片术之前），并在6个月的随访期间保持稳定。无晶状体眼患者取出表层角膜镜片术后，恢复了表层角膜镜片术之前的初始最佳矫正视力和屈光状态。2例近视性白内障患者在白内障摘除和人工晶状体植入术后恢复了原来的最佳矫正视力。
在一个小样本病例系列中，发现即使在7 - 14年后，表层角膜镜片术仍是一种可逆的手术。
