Posters

Prehistoric troubles: hydrops years after epikeratophakia surgery in a keratoconic patient

Poster Details

First Author: E.Livny ISRAEL

Co Author(s):    A. Ben-Arzi   I. Bahar                 

Abstract Details

Purpose:

Epikeratophakia is a historical onlay keratoplasty procedure, introduced for Aphakia and keratoconus in 1982 by Kaufman & Werblin. In this technique, donor corneal grafts were freezed and cut with a designated rotating knife to create a concave lens for aphakia or plano lens to flatten a keratoconic cornea. Visual outcomes were inferior to penetrating keratoplasty with high rate of postoperative residual irregular astigmatism, thus was never popularized. We observed and treated a patient with Hydrops following epikeratophakia in which the epikeratophakic lenticule significantly swell. To the best of our knowledge, this presentation was never described previously in the literature.

Setting:

Tertiary hospital - Rabin Medical Center, Israel

Methods:

A 50 year old woman with history of keratoconus who underwent left eye epikeratophakia procedure 30 years earlier. At presentation she had poor vision in her left eye accompanied with pain, due to an episode of corneal hydrops in the past year with no resolution of the edema of the epikeratophakic lenticule even after intracameral air injection. We proceeded to left eye penetrating keratoplasty. Surprisingly, lenticule removal was easy to perform and penetrating keratoplasty could be done in a straight forward manner.

Results:

Left eye visual acuity improved after surgery to 6/12 with a clear corneal graft.

Conclusions:

Hydrops can occur in epikeratophakic patients even years after the procedure. The comprehensive surgeon should be aware of this 'prehistoric' procedure and its possible complications

Financial Disclosure:

None