The treatment of keratoconus is partly dependent on the severity of the disease process. When contact lenses fail because the patient is intolerant or they do not provide sufficient acuity to meet the patient's needs, penetrating keratoplasty is the usual surgical modality for adequate visual rehabilitation. Keratoconus is considered a contraindication to incisional refractive surgery such as radial keratotomy and laser in situ keratomileusis because of the corneal instability conferred by these procedures. When the cornea is transparent, intrastromal corneal ring implantation is a refractive modality that may improve visual function and, in select keratoconus patients, obviate the need for corneal transplantation.

We report a case of Intacs implantation for keratoconus followed by the implantation of an anterior chamber phakic refractive lens to correct a -8.25 diopter residual error.

Keratoconus is considered a contraindication for refractive surgery because of the potential corneal instability following surgery. On the other hand, penetrating keratoplasty is the usual surgical modality when the keratoconic patient cannot tolerate a contact lens. In some selected cases, when the central cornea is still transparent, refractive surgical procedures, particularly Intacs implantation, may be used to help the patient to improve visual function.

No abstract