Sixty-five epikeratophakia procedures have been performed in 63 patients; visual acuity data have been tabulated on 31 patients with 4 to 30 months follow-up. Patients with more than a year of follow-up showed stable keratometry readings. Early patients achieved 70% of the predicted dioptric correction; more recent patients have achieved 87% with improvements in the lathing procedure, tissue handling, and surgical technique. Visual acuities improve with time. At any given time after surgery, acuities measured with a hard contact lens are better than those measured with spectacles; the decrease in spectacle acuity is probably a result of irregular refraction at the graft surface. The gap between contact lens and spectacle acuity decreases with time. A number of patients achieve postoperative visual acuities better than their preoperative acuities, and most achieve final spectacle acuities within a line or two of their preoperative acuities.