Recurrent keratoconus 40 years after keratoplasty

Recurrent keratoconus is a corneal dystrophy that degrades the optical function of the corneal graft. Recurrence of keratoconus after keratoplasty has been reported previously in some scattered case reports, but the aetiology is still unclear. This report describes the case of a 74‐year‐old white woman, who presented recurrent keratoconus 40 years after keratoplasty. Ophthalmological and videokeratographic data are presented. The patient obtained satisfactory vision with soft contact lenses, and recurrent keratoconus remained stable during a 2‐year period. Recurrent keratoconus generally has a moderate to severe effect on visual performance, but contact lenses usually optimise visual acuity. In cases in which the visual defect is severe, a second penetrating keratoplasty should be considered.