Purpose: To evaluate the efficacy of epikeratophakia for the treatment of severe Terrien's degeneration.
Methods: Four eyes with severe Terrien's corneal degeneration are studied. The lesions were located at the peripheral cornea and the corneal thickness was less then 1/3 of normal. Plano keratoplasty was performed. A lamellar lenticule with a 2 mm scleral rim was grafted on the cornea of which the epithelium had been removed. Keratometry and cycloplegic refraction were performed pre- and post-operatively.
Results: Follow-up was between 3 and 13 months (mean, 10 months). All grafts remain clear. The properative mean cylinder was 11.5 diopters and the postoperative mean cylinder was 3.9 diopters. Best corrected visual acuity was improved in 3 eyes. Interface opacification is the main complication, like other forms of epikeratoplasty. Epithelial ingrowth occurred in one eye and the lenticule was replaced.
Conclusions: Epikeratophakia is a simple and effective way for the treatment of severe Terrien's degeneration. This procedure not only increases the corneal thickness, but also hepls the cornea to preserve its transparency, since the Bowman's layer remains intact.