Temporary Tarsorrhaphy Enhances Reepithelialization After Epikeratoplasty

To the Editor. —Most complications (loss of graft clarity, graft failure or dehiscence, microbial keratitis) following epikeratoplasty are related to delayed or incomplete reepithelialization.1Factors that may contribute to epithelial failure include poor patient selection, inadequate postoperative care or follow-up, and variability in the epikeratoplasty lenticules.1We have examined the effectiveness of bandage soft contact lenses (six cases), pressure patching (29 cases), and temporary tarsorrhaphy (13 cases) in the primary therapy of epithelial defects following epikeratoplasty. All 48 cases (20 adult cases of aphakia, 11 pediatric cases of aphakia, ten cases of keratoconus, and seven cases of myopia) met the criteria2of having no preexisting ocular surface disorder (eg, dry eye or severe blepharitis) that would be expected to compromise epithelial recovery. All epikeratoplasties were performed according to standard protocols.3In each case, the epithelium was débrided with application of 4% cocaine hydrochloride and removal with