Penetrating keratoplasty (PK) may be required for visual rehabilitatio
n or tectonic purposes in patients with severe keratopathy due to atop
ic keratoconjunctivitis (AKC). The outcome of PK is often poor in such
patients because of adnexal and ocular surface abnormalities. We stud
ied nine AKC patients requiring PK and evaluated the visual outcome an
d prognostic factors in 11 eyes. The mean follow-up was 87.2 months (r
ange, 30-180 months). Preoperatively all patients had visual acuity of
hand motion to 20/200. Eighteen grafts were performed. Final visual a
cuity was 20/40 or better in 46% of the eyes. Ten eyes retained clear
grafts and improved an average of 4.5 Snellen acuity lines.