Vision varies a great deal after a transplant and continues to change for many months. It may start out very poor and gradually improve or be very good immediately after surgery and then worsen. It could take up to a year to develop good, stable vision.
The more severe the keratoconus is, the more likely it is to see a dramatic improvement immediately after surgery. This is due to the dramatic change that occurs when the bulging and distorted cone is replaced with a new smooth donor graft. While some patients develop good vision while the sutures are still in place, best, most stable vision usually occurs after all the sutures are removed. Suture removal occurs at different times for different patients. It depends on the rate of healing, which is faster in younger people. The majority of keratoconus patients have their sutures removed 6-12 months after surgery.
An important question is the level of uncorrected vision that can be expected after surgery. Will glasses be an option, or will contact lenses still be needed? A small percentage of transplant patients do obtain uncorrected vision good enough that neither glasses nor contacts are needed after surgery, but in the majority of cases, some form of vision correction is needed after surgery. Although vision may not be perfect after surgery, it is nearly always a lot better than it was before.