Rapid visual recovery after penetrating keratoplasty for keratoconus.
OBJECTIVE
To ascertain the level and speed of visual recovery after penetrating keratoplasty for keratoconus.


METHODS
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 > or = 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.


CONCLUSIONS
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.
Sutton
Gerard
G
Department of Ophthalmology, Sydney Eye Hospital, Sydney, New South Wales, Australia. gsutton@theeyeinstitute.com.au
Hodge
Chris
C
McGhee
Charles N J
CN
D000293:Adolescent; D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000209:etiology; D002648:Child; D003262:Contact Lenses, Extended-Wear; D005139:Eyeglasses; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult