Corneal steepening after epikeratoplasty.

Four patients had removal of their epikeratoplasty lenticules for unsatisfactory visual results. This was out of a consecutive series of 36 eyes. Three eyes were myopic and one was aphakic. In all four eyes, there was significant corneal steepening with an average increase in myopia of 2.4 diopters and an average increase in keratometry reading of 4.8 diopters. Corneoscopy was done in three cases and showed central corneal steepening. In addition, one patient (Case 1) had significant scarring of the recipient cornea and a decrease in visual acuity to 20/100. The reasons for corneal steepening may be related to midperipheral partial trephination, annular keratectomy, and spreading of the peripheral cornea.