Purpose. To determine the prognosis of penetrating keratoplasty in eyes wit
h keratoconus and vernal keratoconjunctivitis. Methods. The medical records
of all patients with keratoconus and vernal keratoconjunctivitis who under
went penetrating keratoplasty at King Khaled Eye Specialist Hospital from J
anuary 1, 1986 to December 31, 1996 and for whom at least 24 months' follow
-up is available were analyzed retrospectively. Results. Of 85 (61 males, 2
4 females) patients, 90 eyes met the inclusion criteria. The mean follow-up
was 44.7 (range, 26-144) months. At the most recent follow-up visit, 83 (9
2.2%) grafts were clear. The mean best corrected visual acuity was 20/40. G
raft rejection episodes occurred in 12 (13.3%) eyes, with irreversible graf
t failure occurring in 4 (4.4%) eyes. Bacterial keratitis occurred in 6 (7.
7%) eyes, 2 (2.2%) of which developed irreversible graft failure. Herpes si
mplex keratitis resulted in irreversible graft failure in 1 (1.1%) eye. Con
clusion. Penetrating keratoplasty in eyes with keratoconus and vernal kerat
oconjunctivitis has an excellent visual outcome and a low complication rate
.