This patient has very advanced keratoconus in both eyes. 4 years ago he visited us from Mexico seeking a solution to his vision loss and to avoid a scheduled corneal transplant operation. When he first came into our office his corrected visual acuity with his eyeglasses was very poor. He had been unable to see clearly with any type of contact lenses. The gas permeable lenses given to him were very uncomfortable and unstable and would often pop out of his eyes. We fit this patient with GVR Scleral lenses which provided him with clear (20/20 in each eye) and comfortable vision with all day lens wear. Over 2 years ago, this patient visited another doctor for Intacs surgery and Collagen Cross-linking therapy. He was under the impression that these 2 procedures would “cure” his keratoconus and eliminate his need to wear the scleral lenses we provided him. Last month this patient returned to our office for a comprehensive eye and lens evaluation. Both of his corneas were clear and healthy. The shape and contour of his corneas were essentially the same as they were 4 years ago as was the status of his keratoconus. The GVR scleral lens design was changed slightly and dispensed to him last week. With his new lenses this patient is still seeing clearly and comfortably. Next to the photo of me and this patient, I posted a photo of the scleral lens over his cornea with the Intacs. Note the “horse-shoe” shape structure just below the pupil. This is a plastic ring (Intacs) that was surgically inserted into the center of the cornea. Both of his corneas look the same. The principle behind this technology is to make the distorted cornea smoother and less irregular. Unfortunately, Intacs does not provide the same therapeutic benefit to every patient. As long as this patient wears his GVR Scleral lenses he will never need to undergo corneal transplant surgery.