Background: The results of penetrating keratoplasty in two centres for cornea transplantation were investigated with regard to the following parameters: the t rephine system used, the origin of the donor cornea, the influence on the postop erative astigmatism and other aspects. Patients and Methods: The retrospective c linical investigation reports about the results of 186 patients with penetrating keratoplasty from the University Eye Hospital of Halle and 204 patients from th e Eye Clinic of the Helios hospital Aue. Results: Three trephine systems have be en used: the Hessburg-Barron trephine, the guided trephine system (GTS) and the Asmotom device. There were no significant differences between them concerning v isual acuity after 12 months postoperatively. The results were highly significan tly better (P=0.003 Halle; P=0.001 Aue) when using larger diameters of the treph ine (7.5 mm and 8.0 mm). The origin of the donor cornea (“fresh”cornea from a deceased subject or organ cultivated cornea from a cornea bank) had no influence on visual outcome after twelve months (P > 0.8). There were less wound dehiscen ces using the double running suture in comparison with other techniques (P=0.05) . The removal of suturing material was not effective in reducing postoperative a stigmatism (P > 0.11). There was no increase in astigmatism when leaving the sut ures in situ (P > 0.25). Conclusions: Generally, each of the three trephine syst ems can be recommended for clinical use. The trephination should be done with tr ephine diameters of 7.5 mm or 8.0 mm. A timely operation guarantees better visua l acuity at one year postoperatively.
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