Outcomes of Epikeratoplasty for Advanced Keratoglobus

‏To determine the visual and anatomic outcomes of epikeratoplasty in 7 eyes of 6 patients with keratoglobus. In a retrospective interventional case series, seven eyes of six patients with keratoglaobus (KGB) aged 5 to 39 years underwent epikeratoplasty. Three patients (3 eyes) had blue sclera, hypermobile joints, and consanguineous parents and 3 patients (4 eyes) had only KGB. In the blue sclera group, all patients had lost the fellow eye due to minor trauma. We used a 10.50 to 13.00 mm corneoscleral graft. Orbscan pachymetry was performed before surgery and 3 months after operation. Mean visual acuity was 20/400 preoperatively and reached 20/160 postoperatively. Mean central corneal thickness was 200µ preoperatively which increased to 800µ after surgery. Epithelial inclusion cyst occurred in one patient. Severe interface vascularization occurred in one eye of the blue sclera group, which had total Descemet`s detachment before epikeratoplasty. Epikeratoplasty is a relatively safe, effective and reversible extraocular procedure for management of KGB. The procedure may be performed to produce corneal flattening and protect against acute corneal hydrops and perforation.