title: Refractive surgery for keratoconus.
abstract: Traditionally, keratoconus has been managed with glasses when mild, contact lenses when moderate and keratoplasty when severe. When cornea-based refractive surgery was first developed it appeared to be a useful option for keratoconus until reports of post-operative progressive ectasia emerged and thus keratoconus was considered a contraindication to refractive surgery. However, improvements in older techniques and the development of new techniques mean that there are now several viable options to avoid keratoplasty in contact lens-intolerant patients. This review discusses the risks and benefits of excimer laser refractive procedures, both with and without corneal collagen cross linking, as well as intra-corneal ring segments, phakic intraocular lenses and refractive lens exchange with toric intraocular lens implantation.
authors.affiliation: Department of Ophthalmology, University of Auckland, Auckland, New Zealand. s.ormonde@auckland.ac.nz
authors.forename: Sue
authors.initials: S
authors.lastname: Ormonde
mesh_terms: D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use; D007910:Lenses, Intraocular; D018903:Photorefractive Keratectomy; D054140:Refractive Surgical Procedures / Q000379:methods*