We used specular microscopy to study the corneal endothelium of eight aphakic patients who had undergone epikeratophakia. The average post-operative period was 16 months with a range of 12 to 18 months. Corneal thickness increased from 0.52 mm +/- 0.01 mm to 0.88 mm +/- 0.04 mm with the addition of the onlay graft. The average pre-operative endothelial cell count was low (1,450 per mm2 +/- 218) and did not differ significantly (p greater than .9) from the average postoperative cell count (1,438 per mm2 +/- 218). Despite the increase in corneal thickness and low endothelial cell counts, we saw no corneal edema. We conclude that epikeratophakia is well tolerated by the cornea and can be performed safely on eyes that have already undergone substantial trauma to the endothelium.
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