Epikeratoplasty for keratoconus. A clinicopathologic case report.

A 20-year-old man with bilateral keratoconus underwent an epikeratoplasty in the left eye. The postoperative course was uneventful. Five years postepikeratoplasty he developed progressive myopia in the operated eye. A contact lens would not remain centered and the spectacle correction in a trial frame was not tolerated. A successful penetrating keratoplasty was performed six years after the epikeratoplasty procedure. Light and electron microscopic studies of the corneal button showed hypocellularity and irregular distribution of the keratocytes in the lenticule and the accumulation of a periodic acid-Schiff-positive, electron-dense fibrillogranular material at the interface between the lenticule and the recipient Bowman's layer.