Magalhaes OA, et al. – The characteristics and outcomes of male and female patients that underwent corneal transplantation for keratoconus (KC) in Southern Brazil and worldwide are compared in this study. According to the outcomes obtained, keratoconus is the most transplanted corneal disease in Southern Brazil and globally. Studies in Africa, Asia, Europe and North America also demonstrated gender differences in KC patients submitted to keratoplasty. They observed that men were transplanted in a 1.9 male/female ratio and at an earlier age than women. At final follow–up, male sex and PK were risk factors related to increased graft failure. It is essential to broaden the hormonal and genetic examinations to clarify why keratoconic males have undergone more keratoplasties and have a more secondary failure than females.