Purpose: To determine whether there is increased risk associated with
excimer laser surgery of primary keratoconus. Setting: Department of O
phthalmology, County Council Hospital, Ryhov, Jonkoping, Sweden. Metho
ds: Twenty-four eyes in 23 patients with keratoconus had photorefracti
ve keratectomy (PRK) to reduce the steepness of the cone. A VISX Twent
y-Twenty B laser.(193 nm) was used for the treatments. Spherical ablat
ions, cylindrical ablations, or both were used. Patients were followed
for a mean of 22 months (range 6 to 46 months). Results: Fourteen pat
ients (58%) had improved visual acuity. Eleven (46%) could manage with
only spectacles, and three (13%) were fitted with contact lenses to g
et adequate visual function. All treated corneas healed, and no accele
ration of the keratoconus was seen. Conclusion: No increased risk was
associated with treating primary keratoconus with excimer laser PRK. W
e found that excimer laser surgery can improve vision and the ability
to wear contact lenses, and it did not interfere with subsequent corne
al transplantation surgery.