Long-term results of corneal transplantations in keratoconus patients.

In this retrospective study all 86 corneal transplantations performed for keratoconus in the Rotterdam Eye Hospital between 1969 and 1978 were included. Sixty seven perforating and 19 lamellar corneal grafts had been performed. The average follow-up was 59 months. Immune reactions occurred 12 times in 11 eyes with a perforating corneal graft (16%); in no case did this lead to permanent opacities in the graft. The visual result of the perforating graft is in general better than that of the lamellar graft. A lamellar graft is indicated, in our opinion, when the risk of trauma is high and the opportunities for follow-up insufficient, and when the peripheral cornea is markedly thin. In most cases we prefer a perforating graft because the results are better.