Epikeratoplasty for adult and pediatric aphakia, myopia, and keratoconus: the Massachusetts Eye and Ear Infirmary experience.

Between February, 1985 and February, 1987, 49 eyes of 47 patients underwent epikeratoplasty for one of the following indications: adult aphakia (21 eyes; 20 patients), pediatric aphakia (10 eyes; 10 patients), myopia (7 eyes; 6 patients), and keratoconus (11 eyes; 11 patients). Follow-up at least 12 months (average = 18 months) is available for all 49 eyes. Of 49 eyes, 44 (90%) were anatomically successful with an intact, clear lenticule at least 12 months post-operatively, with no significant difference between the four groups (adult aphakia = 90%, pediatric aphakia = 90%, myopia = 86%, and keratoconus = 91%). The functional success rate, however, was 91% for keratoconus, 81% for adult aphakia, 80% for pediatric aphakia, and only 43% for myopia. We conclude that epikeratoplasty can be an effective tool in the treatment of carefully selected patients with adult or pediatric aphakia and keratoconus, but has only limited applicability in the management of myopia.