[Epikeratophakia].

Since its introduction by Kaufman in 1979, epikeratophakia has been used successfully in several thousands of patients for the correction of refractive errors. With this technique the original curvature of the cornea is changed by suturing onto it a preshaped lenticule. Depending on the different types of refractive errors to be corrected, the tissue lens is a plus lens (aphakia, hyperopia), a minus lens (myopia), or a plano lens (keratoconus). Both prelated, lyophilized tissue lenses and freshly cut lenticules have been employed with good results. However, the simplicity of the surgical technique, as well as the possibility of rejection of fresh corneal tissue, has made use of the former type of epikeratophakia lenses much more common. The basic indication for epikeratophakia is the incapability of correcting refracting errors with conservative methods, such as glasses, contact lenses or, in cases of aphakia, intraocular lenses. The results obtained in a series of 71 patients who underwent epikeratophakia at our Institute compare favorably to those reported in the literature. Following are some of the factors we identified as being responsible for our improved results: (1) the performance of all surgical procedures by the same corneal surgeon; (2) a longer hospitalization period and thereby closer observation of all patients and possible detection of early complications; (3) long-term postoperative follow-up examinations of all patients by the operating surgeon. In summary, epikeratophakia has been shown to be a safe, effective and potentially reversible procedure for the correction of refractive errors.