Since October 1977, the authors have attempted 32 keratophakias (refractive corneal surgery using an interlamellar homograft disc). Twenty-nine of these were primary and three secondary on aphakic eyes. These cases were divided into two series. In the first series, the dioptric correction was 28.5% less than the amount calculated to correct the aphakic error. In the second series, only 6.5% of the calculated dioptric power remained uncorrected. Keratophakia is an alternative to other modalities of secondary full-time correction of aphakia since the internal eye is not compromised by this secondary procedure as it is with a secondary intraocular implant. Further improvements in instrumentation techniques and mathematic programs will broaden the application of refractive keratoplasty techniques.