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To evaluate visual acuity outcomes and graft survival after full thickness penetrating keratoplasty (PKP) in leprosy patients. Design: Case series of triple procedure (PKP, cataract extraction and intraocular implantation) performed on ten eyes of ten leprosy patients who had dense corneal opacity and best correct visual acuity (VA) of <1/60 preoperatively. Data on preoperative and postoperative VA and ocular complications were extracted from case records of patients. Follow up details were available up to 18 months. Results: VA improved in eight out of ten patients from <1/60 preoperatively to a range of 5/60 to 6/24 postoperatively at 6 months and the VA was stable at 12 months. Two patients had graft failure with no improvement in VA. Four patients had mild to moderate graft rejections that responded satisfactorily to medical treatment. Epithelial erosion was observed in all patients and was the only complication seen in four patients. None of the epithelial erosions progressed to deep ulcers or epithelial reactions. Conclusion: In the majority of eyes, visual acuity improved after corneal transplantation. PKP should be offered to blind leprosy patients who have the potential to recover vision, after carefully individualizing the risks and benefits.

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