Clear lens Extraction and Epikeratophakic Lenticule Removal in Complicated Epikeratophakic Patients

ABSTRACT

PURPOSE: To assess clinical outcome of clear lens extraction in high myopia after epikeratophakic (EKP) lenticule removal and to evaluate the change of cornea in EKP. METHODS: The retrospective study reports 5 eyes of 3 patients who underwent clear lens extraction (CLE) after EKP lenticule removal to treat myopia. The changes in best corrected and uncorrected visual acuity, spherical equivalent and corneal refractivity were evaluated before and after EKP, EKP lenticule removal and CLE. RESULTS: The cornea was clear, but the refractive power and astigmatism of cornea increased after EKP lenticule removal. The degree of change of the cornea seemed to be associated with the period between the EKP lenticule removal and the CLE. The BCVA in 3 of 5 eyes returned to the pre-EKP level after CLE. The eye that underwent CLE without EKP lenticule removal revealed severe overcorrected hyperopia and was corrected after CLE. The eye that had CLE without the EKP lenticule removal showed the overcorrection postoperatively but it was corrected after the EKP lenticule removal. CONCLUSIONS: The CLE following EKP lenticule removal can be an effective refractive surgery in complicated EKP patients. To obtain the accurate refractive estimate postoperatively, it is better to perform EKP lenticule removal preceding CLE.