The rate of visual recovery after penetrating keratoplasty for keratoconus.

PURPOSE: We performed a retrospective study of 68 patients who underwent penetrating keratoplasty (PK) for keratoconus during the years of 1988 and 1989. The purpose of this study was to determine the speed of visual recovery, final best corrected visual acuity, and rate of rejection episodes.

METHODS

The visual acuity, type of correction, and complications were recorded at 3, 6, 12, 18, 24, 36, and 48 months.

RESULTS

The average final best corrected visual acuity was 20/23, and all patents achieved 20/30 or better vision (range: 20/15 to 20/30). The best vision was achieved at 16.5 +/- 8.7 months. Thirty-one percent of the patients were corrected with contact lenses. Factors associated with best corrected vision were preoperative vision, combined suture technique, and a donor/host size disparity of 0.25 mm (P < 0.005). Thirty-one percent of the patients had at least one episode of graft rejection. The use of contact lenses was not associated with an increased risk of rejection.

CONCLUSIONS

PK for keratoconus yields an excellent visual result, but this study shows the need for long-term careful follow-up to achieve optimal visual rehabilitation.