Refractive keratoplasty. Keratophakia and keratomileusis

Early experience with the refractive keratoplasty techniques of José Barraquer--keratophakia and hypermetropic keratomileusis is presented. In contradistinction to the alloplastic lens substitutes currently being employed for the integral correction of aphakia, Barraquer's techniques would seem to offer a more permanent, more physiologic, full-time optical correction of the aphakic state. Their use is limited only by the condition of the patient's cornea and, in fact, may be applied not only in aphakia but also in phakic eyes with higher degrees of hyperopia or myopia. In the opinion of the authors, the refractive keratoplasty techniques of Barraquer can be performed by any well-instructed ophthalmic surgeon. These techniques offer to many patients a satisfactory, and potentially a physiologically superior alternative to alloplastic lens substitute for aphakic correction.