Penetrating keratoplasty for keratoconus with or without vernal keratoconjunctivitis

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).

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.

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).

Graft survival, postoperative complications, and visual outcome are comparable after PKP for KC in eyes with or without VKC.