Keratoconus. Evaluation of recent trends in the surgical and nonsurgical correction of keratoconus.

Recent focus on the optical correction for "contact lens failure" keratoconus patients has been in the use of epikeratoplasty as an alternative to penetrating keratoplasty. In a 2-year retrospective review of keratoconus patients, 33 were referred as "contact lens failures" and as such might be considered candidates for surgical intervention. Of these, 29 patients (average keratometry, 50.4; range, 43-73) were successfully refitted with contact lenses. All patients obtained wearing times of 12 hours and achieved a visual acuity of 20/40 or better, with 85% realizing 20/30 or better. The data suggest that with concerted effort most keratoconus patients may be successfully refitted despite initial contact lens failure.