Epikeratophakia for keratoconus.

Results of the author's first 15 cases of epikeratophakia for keratoconus are presented. All patients were intolerant of contact lens correction and could not achieve satisfactory acuity with spectacle correction due to corneal ectasia and irregular astigmatism. The average follow-up was 13 months. Seventy-three per cent of eyes treated had a pre-operative spectacle acuity of 6/60 or worse. One eye had a preexisting amblyopia that limited final acuity, but every other eye achieved a post-operative spectacle acuity of 6/12 or better and 50% achieved 6/6. One eye had 11 dioptres of post-operative astigmatism and required penetrating keratoplasty; the remaining eyes had an average astigmatism of 1.9 dioptres. Epikeratophakia appears to be a safe alternative to penetrating keratoplasty in selected cases.