Hyperopic keratoconus.

Purpose: To report three patients (four eyes) with hyperopic keratoconus.

Methods: Patients were evaluated with corneal curvature topography, ultrasonic pachymetry, and rotating Scheimpflug camera.

Results: One patient, without other risk factors, developed unilateral ectasia after LASIK following primary hyperopic ablation in an eye suspicious for keratoconus. Two additional hyperopic patients (three eyes) had curvature and elevation findings compatible with keratoconus.

Conclusions: Although rare, keratoconus could present in hyperopia. If keratoconus is suspected, we suggest avoidance of LASIK and its potential for development of corneal ectasia.