MANAGEMENT OF PERFORATIONS DURING EPIKERATOPLASTY FOR KERATOCONUS

Epikeratoplasty (EKP) in keratoconus generally has few intraoperative complications. Perforations during EKP are rare but may force the surg eon to abandon the procedure. We developed a special suture technique to manage this problem. Several deep mattress sutures are placed by ta king shallow bites of the central corneal rim and deep bites of the pe ripheral corneal rim. This leaves the peripheral corneal rim projectin g forward by approximately one third the corneal thickness. Slight str etching of this peripheral corneal rim allows adaptation of the epilen ticule to form a smooth tissue plane. This method was used in two pati ents with significant corneal scarring and led to satisfactory visual results.