Perforating keratoplasty in patients with keratoconus.

Aim: Keratoconus is the most common indication for corneal transplantation with high success rate and low number of complications. The aim of this study was to investigate the level and speed of visual recovery after penetrating keratoplasty (PK) for keratoconus patients in first year after transplantation. Patients and methods: This prospective study includes 38 keratoconus patients which underwent PK in Eye Clinic Svjetlost in one year. All patients had best corrected visual acuity (BCVA) ≤ 0.3 and were unable to wear contact lens. In 31 patients PK was performed for the first time, while in 7 patients it had been already performed on the other eye. Results: Graft remained clear in 100 % of patients in first 6 months and in 97.7 % in 1 year observation period. Average BCVA after 1 month was 0.53 ± 0.23 (P < 0.001), after 6 months 0.69 ± 0.22 (P < 0.001) and after 1 year (n = 25) it was 0.81 ± 0.14 (P < 0.001). The leading postoperative complication was high postoperative astigma-tism (>4dcyl) in 44.7 % of patients, graft reaction in 13.2 %, intraocular pressure elevation in 5.2 %, graft rejection in 2.6 % and cataract formation in 2.6 % of patients. Discussion: Lamel-lar keratoplasty is often suggested as method of choice in keratoconus treatment. In this study we have shown that a conventional PK gives adequately good success rate. Conclusion: Penetrating keratoplasty is effective method in treating keratoconus patients with low visual acuity unable to wear contact lens. Success rate is 97.7 %. The most frequent complication is high postoperative astigmatism which occurs in 44.7 % of patients.