title: Penetrating keratoplasty for keratoconus: visual outcome and success.
abstract: OBJECTIVE
  To determine the long-term effect on vision of penetrating keratoplasty performed for keratoconus.
  
  
  METHODS
  Retrospective noncomparative case series.
  
  
  METHODS
  All patients with keratoconus who received a corneal graft and who remained in our center for follow-up and visual rehabilitation during the study period.
  
  
  METHODS
  Penetrating keratoplasty was performed in 93 eyes of 78 patients.
  
  
  METHODS
  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 acuity is (best-tolerated correction) were 0.9 (20/160) and 0.24 (20/80) logMAR, respectively. Visual acuity in 86% of eyes was 0.3 logMAR (20/40) or better at the latest follow-up, with 67% of eyes being corrected with spectacles. Mean preoperative corneal power by keratometry was more than 52 diopters (D) in 83% of eyes; mean postoperative corneal power was 45 +/- 2 D. No significant predictors of postgraft astigmatism were found. Mean preoperative 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 predicted from preoperative factors. Visual acuity measured in the better eye improved by 0.14 logMAR (1.4 lines), implying an overall functional gain for the patient.
authors.affiliation: Department of Ophthalmology, Flinders Medical Centre, Flinders University of South Australia, Bedford Park.
authors.forename: L
authors.initials: L
authors.lastname: Lim
authors.forename: K
authors.initials: K
authors.lastname: Pesudovs
authors.forename: D J
authors.initials: DJ
authors.lastname: Coster
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000175:diagnosis / Q000503:physiopathology; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology*