The disorder that is characterised by excessive thinning of cornea is called keratoconus. Due to this excessive thinning of cornea the eye gets vulnerable to a number of other health conditions.

Study of outcomes of modified microkeratome-assisted lamellar keratoplasty (LK) for the treatment of keratoconus was required over the years i.e. span of 10 years.

The sample of 151 consecutive eyes with keratoconus underwent modified microkeratome-assisted LK. Outcome measures were best spectacle-corrected visual acuity (BSCVA), refractive astigmatism (RA), endothelial cell density, immunological rejection, ectasia recurrence and graft failure rates.

Baseline BSCVA (0.89±0.31 logarithm of the minimum angle of resolution (logMAR)) significantly improved to 0.10±0.12 logMAR at year 3 (p<0.001), and remained stable up to 10 years. At 10 years, 94% of eyes saw ≥20/40, 61% saw ≥20/25 and 24% saw ≥20/20 Snellen BSCVA. At final follow-up, RA exceeding 4.5 dioptres was observed in 5 cases (4%). Endothelial cell loss was 25±17% at 1 year with an annual decline of 2% over 10 years. The 10-year cumulative risk for immunological rejection and graft failure was 8.5%, and 2.4%, respectively. No case developed recurrent ectasia at 10 years.

LK results in stable visual and refractive outcomes with low rates of immunological rejection and graft failure in the absence of recurrence of ectasia for at least 10 years.