Penetrating keratoplasty for keratoconus

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Keratoconus is a progressive thinning of the cornea, often leading to irregular astigmatism and reduced vision.
• Penetrating keratoplasty (corneal transplant) is a common surgical intervention for advanced keratoconus.
• Assessing visual outcomes and optical correction needs post-keratoplasty is crucial for patient management.

Purpose of the Study:

• To evaluate visual acuity outcomes after penetrating keratoplasty in patients with keratoconus.
• To determine the necessity and types of optical correction required post-corneal transplant.

Main Methods:

• Retrospective review of 123 eyes from 94 keratoconus patients undergoing penetrating keratoplasty (1983-1996).
• Collected data included best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), and optical correction type (spectacles vs. contact lenses).
• Data analyzed at 12 and 18 months postoperatively, considering graft rejection and other complications.

Main Results:

• Significant improvement in BCVA observed between 12 and 18 months post-keratoplasty (p < 0.05).
• At 18 months, 87% of patients achieved 20/40 or better BCVA; 47% required contact lenses, and 30% required spectacles.
• Graft rejection and other complications did not significantly impact the achievement of 20/40 vision.

Conclusions:

• Penetrating keratoplasty yields positive visual outcomes for keratoconus patients.
• The majority of patients will require spectacles or contact lenses for functional vision after corneal transplantation.
• Ophthalmologists should counsel patients on the high likelihood of needing optical correction post-surgery.