The study was done to evaluate the anatomical and functional outcomes of autologous contralateral penetrating keratoplasty.

Thirty-one eyes of 31 patients of which there were 19 men, with a mean age of 52±18 years (range 15–81 years) were studied during a mean follow-up of 11.3 years. At 12 months postoperatively, all the recipient eyes showed a transparent cornea, but 23% showed functional failure. At the final follow up, 16 recipient eyes showed anatomical and functional success.

74% showed a clear cornea and 68% reached a better BCVA when compared with preoperative measurements. Nevertheless, 42% displayed functional failure. The cumulative probabilities for anatomical success were 100%, 72% and 48% and 77%, 59% and 29% for functional success at 1, 10 and 40 years, respectively. The most common risk factor for failure was progression of previous glaucoma in 50% of the anatomical failures and in 77% of the functional failures.

The study concluded that autokeratoplasty could be a successful long-term option in patients having one eye with a clear cornea but with irreversible visual dysfunction and the contralateral eye having favourable visual potential limited only by a completely opacified cornea. Progression of previous glaucoma was the most important risk factor for long-term corneal decompensation and visual functional failure in the sample.