• corneal graft;
  • double-suture;
  • keratoconus


Purpose:  To ascertain the level and speed of visual recovery after penetrating keratoplasty for keratoconus.

Method:  A retrospective review was performed of 100 consecutive cases of penetrating keratoplasty for keratoconus, performed between 1999 and 2005. Review assessed visual function and the speed at which patients achieved a functional best corrected visual acuity (BCVA) of ≥6/12 either with glasses or phoropter. Analysis of visual, refractive and keratometric results were made on 76 eyes that had reached 6 months after suture removal. Intraoperative and postoperative complications including graft rejections were recorded.

Results:  Post keratoplasty, 43.4%, 78.9% and 96.1% of patients achieved a BCVA of 6/12 or better by 1, 3 and 6 months, respectively. The mean time to achieve a BCVA of 6/12 was 9.6 weeks. Only 5.3% of patients required a rigid gas permeable contact lens. Overall 42.4% of patients had unaided visual acuity of 6/12 or better at 12 months. The mean refractive cylinder and standard deviation was 2.78 ± 1.6 D, and the mean spherical equivalent was −1.12 ± 2.9 D. There were no significant intraoperative complications, and although 3.9% of eyes had at least one graft rejection episode there were no graft failures.

Conclusion:  Penetrating keratoplasty is an effective method for treating advanced keratoconus. By 3 months almost all patients are able to achieve a BCVA of 6/12 or better with progressive improvement over time. This technique allows almost half of patients to achieve an unaided vision of 6/12 or better with sutures in situ.