The optical correction of aphakia following cataract extraction remains a problem for which no perfect answer is yet available. Spectacles, contact lenses, and intraocular lenses may provide adequate optical correction. Unfortunately, many patients are not suitable candidates for any of these three modalities. Refractive keratoplasty, specifically keratophakia, is a surgical procedure which may provide an alternative for the optical correction of aphakia in those instances where other methods cannot be used. Basically, keratophakia is the insertion of an intracorneal implant or lenticule consisting of stroma from a donor cornea, meticulously carved to precalculated dimensions. Keratophakia was developed 20 years ago by Dr. Jose Barraquer, yet it has not been widely used because of the complexity of the procedure and because of the need for donor corneal material. A method of long term preservation by lyophilization of corneal lenticules for refractive keratoplasty was devised. Preliminary studies show that homologous and heterologous lenticules remain transparent for 3 months. Our objective is to perform keratophakia with homologous and heterologous lyophilized lenticules and to establish whether the accurte optical correction can be obtained. If this method to be safe, effective and accurate, the Lions-Doheny Eye Bank will develop a method of procedure for grinding, storing, and shipping lyophilized lenticules for refractive surgery.
