Epikeratophakia (also known as epikeratoplasty and onlay lamellar keratoplasty) is a refractive surgical procedure in which a lamella of a donor

cornea The cornea is the transparency (optics), transparent front part of the eyeball which covers the Iris (anatomy), iris, pupil, and Anterior chamber of eyeball, anterior chamber. Along with the anterior chamber and Lens (anatomy), lens, the cornea ...

is transplanted onto the anterior surface of the patient's cornea. A lamellar disc from a donor cornea is placed over the de-epithelialized host cornea and sutured into a prepared groove on the host cornea. Indications include treatment of

keratoconus Keratoconus is an eye disorder in which the cornea, the transparent front part of the eye, gradually thins and bulges outward into a cone shape. This causes distorted vision, including blurry vision, double vision, increased nearsightedness, ...

refractive error Refractive error is a problem with focus (optics), focusing light accurately on the retina due to the shape of the eye and/or cornea. The most common types of refractive error are myopia, near-sightedness, hyperopia, far-sightedness, astigmatis ...

s like

myopia Myopia, also known as near-sightedness and short-sightedness, is an eye condition where light from distant objects focuses in front of, instead of on, the retina. As a result, distant objects appear blurry, while close objects appear normal. ...

and high

hypermetropia Far-sightedness, also known as long-sightedness, hypermetropia, and hyperopia, is a condition of the eye where distant objects are seen clearly but near objects appear blurred. This blur is due to incoming light being focused behind, instead o ...

including

aphakia Aphakia is the absence of the lens of the eye, due to surgical removal, such as in cataract surgery, a perforating wound or ulcer, or congenital anomaly. It causes a loss of ability to maintain focus ( accommodation), high degree of farsightedn ...

, which cannot be corrected with conservative methods. __TOC__

Complications

Common complications of epikeratophakia include delayed post operative visual recovery, reduced best corrected

visual acuity Visual acuity (VA) commonly refers to the clarity of visual perception, vision, but technically rates an animal's ability to recognize small details with precision. Visual acuity depends on optical and neural factors. Optical factors of the eye ...

, prolonged epithelial defects and irregular

astigmatism Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. The lens and cornea of an eye without astigmatism are nearly spherical, with only a single radius of curvature, and any refractive errors ...

History

In 1949, José Barraquer introduced refractive procedure of inclusion of a lenticule within the corneal stromal layer. In 1980s, based on Barraquer's procedure, Werblin, Kaufman and Klyce at the LSU Eye Center introduced epikeratophakia.

References

Refractive surgeries {{Surgery-stub