Penetrating keratoplasty for keratoconus

Purpose, We performed a retrospective study of patients with keratoconus wh o underwent penetrating keratoplasty at the University of California, Davis , during the years 1983-1996 to analyze subsequent Visual acuity and the ne ed for optical correction. Methods. We reviewed 123 eyes of 94 patients and collected data including best corrected visual acuity (BCVA) and uncorrect ed visual acuity (UCVA), type of correction (contact lens vs. spectacles), incidence of rejection, and other complications. Data were obtained at 12 a nd 18 months postoperatively. Results. There was a significant improvement of the BCVA between 12 and Is months (p < 0.05) and no significant improvem ent in UCVA between at the same times (p = 0.222). At 12 months postoperati vely, 84%, and at 18 months, 87% of patients achieved 20/40 or better BCVA. At 18 months, 47% of eyes were fit with contact lenses, and 30%, with spec tacles. Mean spherical refraction was -4.13 D +/- 4.41 standard deviation ( SD) at 12 months and -4.09 D +/- 3.86 SD at 18 months, whereas mean cylinde r was 2.52 D +/- 2.45 SD and 2.67 D +/- 2.04 SD, respectively. Of the eyes, 17.9% had at least one graft rejection, although rejection episodes did no t significantly influence the incidence of 20/40 vision (p = 0.084). Combin ed nonrejection complications did not significantly influence incidence of 20/40 or better Vision at 18 months (p > 0.10). Conclusion. This study reaf firms that the results for keratoplasty in keratoconus are very positive an d emphasizes that ophthalmologists should counsel patients about the likeli hood of the need for spectacle or contact lens correction. Our data demonst rate that the majority of patients require optical correction for functiona l visual acuity after keratoplasty.