>I  have  advanced keratoconus in both eyes. I was advised keratoplasty
>for correcting both eyes. I was wondering what I can expect from the
>surgery in terms of vision and what precautions need to be followed
>as a result of the surgery.

The Ophthalmologist I work for tells his potential patients that they can
expect a 90% chance of 20/20 vision post-operatively, with correction.  The
post-operative healing period is quite long, however, and it sometimes takes
several months to have vision stablize.  Sutures are left in for as long as
a year or more, and a stable refraction is often not achieved until all
sutures are removed.

The biggest problem for transplant patients is rejection, but this is
usually controlled well with anti-inflammatory medications.  We always
stress that patients must get to us quickly if there are any early signs of
rejection, such as an increase in irritation or a decrease in vision.

Of the 30 odd patients I have helped to treat since I’ve been employed in
the practice, I can only think of one who’s had recurrent rejection
symptoms, and he’s usually a bit non-compliant about getting in soon, or
using his eyedrops when he should.  So far, however, we’ve been able to head
off every episode, and he still has very good vision.  I can’t think of any
of our patients who have had a less than desirable visual rehabilitation
given that all other aspects of the ocular system are in working order, i.e.
absense of lens opacities or retinal problems.