Epikeratophakia


Epikeratophakia is a type of refractive surgery that was once commonly used to correct vision problems such as nearsightedness (myopia) and astigmatism. The procedure involves replacing the central portion of the cornea, the clear, dome-shaped surface of the eye, with a donor corneal tissue. Epikeratophakia was often performed in conjunction with other types of refractive surgery, such as radial keratotomy (RK).

History of Epikeratophakia

Epikeratophakia was first developed in the 1950s and gained popularity in the 1970s and 1980s as a way to correct vision problems without the need for eyeglasses or contact lenses. The procedure was performed using a surgical instrument called a cryoprobe, which was used to freeze the central portion of the cornea and remove it. The donor tissue was then sutured into place and allowed to heal naturally.

However, the popularity of epikeratophakia began to wane in the 1990s due to the development of newer, safer, and more predictable refractive surgery procedures, such as laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). Epikeratophakia is now rarely performed and is considered an outdated procedure.

How Epikeratophakia is Performed

Epikeratophakia is typically performed on an outpatient basis, with the patient receiving local anesthesia to numb the eye. The procedure typically takes about 30-60 minutes to complete.

During the procedure, the surgeon will use a surgical instrument to remove the central portion of the cornea, known as the cap. The donor tissue, which has been carefully matched to the patient's cornea in terms of shape and size, is then sutured into place using fine nylon or silk sutures.

Risks and Complications of Epikeratophakia

Epikeratophakia carries a number of potential risks and complications, including:

  • Infection
  • Overcorrection or undercorrection of the refractive error
  • Irregular astigmatism
  • Dry eye
  • Decreased night vision
  • Loss of visual acuity

In addition, epikeratophakia is not a reversible procedure. If the patient experiences problems or is unhappy with the results, additional surgery may be required to correct the issue.

Alternative Refractive Surgery Procedures

As mentioned previously, epikeratophakia has largely been replaced by newer, safer, and more predictable refractive surgery procedures such as LASIK and PRK. These procedures involve the use of a laser to reshape the cornea rather than replacing it with donor tissue.

LASIK is the most commonly performed refractive surgery procedure and has a high success rate and a low risk of complications. It involves the creation of a thin flap on the surface of the cornea, which is lifted to reveal the underlying corneal tissue. The laser is then used to reshape the tissue and correct the refractive error. The flap is then repositioned and allowed to heal naturally.

PRK is similar to LASIK, but it does not involve the creation of a corneal flap. Instead, the outer layer of the cornea (the epithelium) is removed and the underlying corneal tissue is reshaped using the laser. The epithelium will then regenerate naturally over the next few days. PRK may be recommended for patients with thin corneas or other conditions that may make them poor candidates for LASIK.

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