Evaluation of functional and morphologic parameters of the cornea after epikeratophakia using prelathed, lyophilized tissue.

Up to now, the attention of ophthalmic surgeons has been focused mainly on the clinical results of epikeratophakia, demonstrating its safety, relative predictability, and capability of correcting a wide range of refractive errors. However, no prospective study has ever been undertaken to evaluate the influence of epikeratophakia on various physiologic and morphologic parameters of the cornea. The authors investigated some of these parameters prospectively in eight consecutive patients undergoing epikeratophakia with prelathed, lyophilized tissue. Fluorophotometric evaluation of the epithelial barrier function, corneal densitometry by means of Scheimpflug photography, and endothelial specular microscopy were performed preoperatively and 2, 4, 8, 12, and 24 weeks after epikeratophakia. The epithelial barrier function was shown to return to normal 4 weeks after surgery. The optical density of both the epi-lenses and the host corneas increased early after surgery, but was comparable to that of unoperated corneas 6 weeks postoperatively in all cases but one. The endothelial cell density was not altered by surgery in any patient. Despite the limited number of patients, this study indicates that most functional and morphologic parameters of the cornea are normal as early as 6 weeks after epikeratophakia in most cases.