title: Penetrating keratoplasty for keratoconus with or without vernal keratoconjunctivitis.
abstract: OBJECTIVE
  The purpose of this study was to evaluate graft survival, postoperative complications, and visual outcome after penetrating keratoplasty (PKP) for keratoconus (KC) in eyes with or without a history of vernal keratoconjunctivitis (VKC).
  
  
  METHODS
  A retrospective review was conducted on all cases of PKP performed at King Khaled Eye Specialist Hospital between January 1, 1997, and December 31, 2001, for KC.
  
  
  RESULTS
  Four hundred sixty-four eyes were included in the study, including 80 (17.2%) eyes with VKC and 384 (82.8%) without VKC. Five-year graft survival was 97.3% and 95.5% in eyes with or without VKC, respectively. There were no statistically significant differences in Kaplan-Meier graft survival between the 2 groups at any time interval. There were no statistically significant differences in the percentage of eyes experiencing postoperative complications in eyes with or without VKC (27.5% vs 31.8%, respectively; P = 0.50). However, late-onset persistent epithelial defects were significantly more likely to occur in eyes with VKC (6.3% vs 1.8%; P = 0.04). There were no significant differences in the prevalence of endothelial rejection, bacterial keratitis, glaucoma, wound dehiscence, early-onset persistent epithelial defects, or secondary cataract. The median final best-corrected visual acuity was 20/30 in both groups. The percentage of eyes with a final best-corrected visual acuity of 20/40 or better was 76.2% in eyes with VKC and 71.9% in eyes without VKC (P = 0.49).
  
  
  CONCLUSIONS
  Graft survival, postoperative complications, and visual outcome are comparable after PKP for KC in eyes with or without VKC.
authors.affiliation: Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia. michael-wagoner@uiowa.edu
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wagoner
authors.forename: Rola
authors.initials: R
authors.lastname: Ba-Abbad
mesh_terms: D000293:Adolescent; D000328:Adult; D003233:Conjunctivitis, Allergic / Q000150:complications*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007640:Keratoconus / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000009:adverse effects; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult