Penetrating keratoplasty after epikeratophakia for keratoconus

Seven patients underwent penetrating keratoplasty after epikeratophakia for keratoconus. All seven patients achieved clear grafts and 20/40 or better best corrected visual acuity after penetrating keratoplasty. Three of the seven patients had one or more episodes of rejection after penetrating keratoplasty; all were treated successfully. No grafts were lost. The results in terms of graft clarity and visual acuity are comparable with those in patients undergoing penetrating keratoplasty for keratoconus with no previous ocular surgery. Whether the relatively high rate of rejection episodes (three [43%]) seen in this small number of patients indicates some relationship between previous epikeratophakia and subsequent rejection after penetrating keratoplasty remains to be seen.