Sterile Stromal Melt of Epikeratoplasty Lenticule

A variety of postoperative complications can occur after epikeratoplasty. Poor reepithelization of the lenticule surface has been a major clinical problem and may lead to aseptic stromal necrosis (corneal melting). We describe a patient who received a nonfreeze epikeratoplasty followed by aseptic necrosis of the lenticule in the absence of a preexisting epithelial defect. Report of a Case. —A 70-year-old man was referred to the Emory Eye Center, Atlanta, Ga, in September 1989 for evaluation of his left eye, which had undergone extracapsular cataract extraction with an intraocular lens implant in 1982. The intraocular lens had been removed in 1984 because of inflammation and dislocation. The patient had previously undergone panretinal photocoagulation for diabetic retinopathy. His best spectacle-corrected visual acuity was 20/25 OD and 20/400 OS. Since he was intolerant of contact lenses, a nonfreeze, aphakic epikeratoplasty was performed on the patient's left eye. Two weeks after the procedure the