Long-term reversibility of epikeratophakia

Purpose: To assess the long-term reversibility of epikeratophakia. Methods: Three human epikeratophakia lenticules (from 3 patients) were removed 7-14 years after refractive keratoplasty for aphakia (n - 1) and myopia (n = 2). Reasons for removal were irregular astigmatism (n - 1), opacities in the graft and host cornea, and progressive myopia (n - 2). After removal, 2 patients underwent cataract extraction and I underwent secondary implantation of an anterior-chamber intraocular lens (IOL). Visual acuity, refraction, keratometry, and corneal topography were assessed before and after removal of the lenticule, as well as after the cataract and IOL implantation, and were compared with the initial visual acuity and corneal curvature before epikeratoplasty. Results: After removal of the lenticule, the 3 patients regained the initial curvature of the cornea (preepikeratoplasty) and remained stable during 6 months of follow-up. Initial best-corrected visual acuity and refraction before epikeratoplasty were restored after removal of the epikeratoplasty lenticule in the aphakic patient. Original best-corrected visual acuity was restored in the 2 myopic cataract patients after cataract extraction and IOL implantation. Conclusions: In a small case series, epikeratophakia was found to be a reversible procedure even after 7-14 years.