Minimally invasive approaches to management of keratoconus.

Purpose of review: Keratoconus is one of the leading indications for corneal transplantation surgery. Although the surgical success rate is high, the long-term outcomes do not match other solid organ transplantation procedures. The availability of minimally invasive techniques has led to a reduction in the number of corneal transplantations in addition to improved visual outcomes in patients with keratoconus.

Recent findings: Collagen crosslinking slows down or stops disease progression in keratoconus. Customized contact lenses provide patient comfort and excellent visual outcomes. Bowman's layer onlay grafts have demonstrated promising outcomes in keratoconus patients. Corneal regeneration approaches provide hope as the next generation treatment option.

Summary: Minimally invasive treatments for keratoconus patients enable alternatives to corneal transplantation. This review summarizes some of the commonly used management approaches with a view into the future.