Keratoconus is a congenital disorder characterized by central progressive protrusion of the cornea. Keratoconus usually presents with progression of myopia and astigmatism on the second to third decades of life. Patients with mild keratoconus can perform normal daily activities with glasses or contact lenses. However, severe cases cannot be handled by spectacle or contact lens wear. In such cases, keratoplasty has been a recommendable last measure to solve the long-term visual problems. Recently, several new surgical modalities for keratoconus have been developed. We will assess each individual patients age and disease condition, and tailor the best possible approach for improvement of vision and quality of life.