Penetrating keratoplasty for keratoconus: Visual outcome and success

Objective: To determine the long-term effect on vision of penetrating kerat oplasty performed for keratoconus. Design: Retrospective noncomparative case series. Participants: All patients with keratoconus who received a corneal graft an d who remained in our center for follow-up and visual rehabilitation during the study period. Intervention: Penetrating keratoplasty was performed in 93 eyes of 78 patie nts. Main Outcome Measures: Graft survival, visual acuity, and astigmatism. Results: One (1.08%) graft failure was encountered over a mean follow-up of 46 months. Mean preoperative (best corrected) and postoperative visual acu ity is (best-tolerated correction) were 0.9 (20/160) and 0.24 (20/80) logMA R, respectively. Visual acuity in 86% of eyes was 0.3 logMAR (20/40) or bet ter at the latest follow-up, with 67% of eyes being corrected with spectacl es. Mean preoperative corneal power by keratometry was more than 52 diopter s (D) in 83% of eyes; mean postoperative corneal power was 45 +/- 2 D, No s ignificant predictors of postgraft astigmatism were found, Mean preoperativ e and postoperative best-eye acuities of the better eye were 0.32 (20/40-1) and 0.18 (20/32+1) logMAR, respectively (P < 0.001). Conclusions: Graft survival was excellent. A corrected visual acuity of 20/ 40 or better was obtained in 86% of eyes. Astigmatism could not be predicte d from preoperative factors, Visual acuity measured in the better eye impro ved by 0.14 logMAR (1.4 lines), implying an overall functional gain for the patient. Ophthalmology 2000; 107:1125-1131 (C) 2000 by the American Academ y of Ophthalmology.