We reviewed the consecutive records of 296 patients who underwent corneal transplantation at our institution to compare visual outcome between those who underwent double continuous suture wound closure and those who underwent a combination of interrupted and continuous suture wound closure. Of 156 patients on whom one of these closure techniques was performed, 33 patients satisfied our inclusion and exclusion criteria. Visual outcome between the two groups was compared at three, six, and 12 months. We found significant differences (P less than .05) in average corneal curvature and refractive spherical equivalents (steeper and more myopic, respectively, for double continuous suture wound closure); keratoscopic astigmatism, refractive cylindrical error; and average number of postoperative visits (greater for combined interrupted and continuous suture wound). Visual acuity without correction was significantly better at three months in the group that received double continuous sutures (P = .026). We found no marked difference in best-corrected visual acuity, frequency of graft rejection, requirement for contact lens fit, ratio of refracted vs potential visual acuity, or intraocular pressure. Patients who underwent double continuous suture closure had more rapid visual rehabilitation, had steeper corneas, and less astigmatism than patients who underwent the combined technique suture closure.