The nationwide study of epikeratophakia for aphakia in children.

In the nationwide study of epikeratophakia, 97 surgeons performed a total of 335 procedures in 314 eyes for the correction of aphakia in children under the age of 8 years 1 month. Fifteen children underwent bilateral surgery. Thirty-six tissue lenses were removed and 21 of these eyes underwent a second epikeratophakia procedure. Overall, the success rate for procedures was 89%, and with repeated surgery it was 95% for eyes. Seventy-three percent of the patients were within 3 diopters of emmetropia after surgery. Visual acuity results in patients able to provide verbal responses to the illiterate E, Allen card, or Snellen line chart testing showed improvement in most cases. The safety of epikeratophakia makes it a desirable option for the correction of aphakia in children who are spectacle or contact-lens intolerant, and the permanence of the correction eliminates the problem of optical noncompliance.