Lamellar keratectomy and repeat epikeratoplasty following failed epikeratoplasty. A clinicopathologic report.

Although epikeratoplasty (epikeratophakia) for aphakia in children has achieved a high degree of success, there remains a significant incidence of complications, some of which may result in removal of the lenticule. We report a 2-year-old child in whom epikeratoplasty was followed by an acute suppurative keratitis, necessitating removal of the epikeratoplasty lenticule. The recipient bed remained scarred following removal of the lenticule with anterior stomal fibrosis, which precluded good vision. We were able to avoid a penetrating keratoplasty by performing a superficial lamellar keratoplasty with a repeat epikeratoplasty that has remained clear.