Corneal Collagen Crosslinking and Intacs for Keratoconus and Ectasia

Inclusion Criteria: * 21 years of age or older * Having a diagnosis of keratoconus or corneal ectasia after corneal refractive surgery (e.g., LASIK, photorefractive keratectomy \[PRK\], or epi-LASIK) * Subjects who meet the manufacturer's nomogram recommendations for Intacs segments * Topography consistent with keratoconus or post-surgical corneal ectasia. * BSCVA worse than 20/20 (\<55 letters on ETDRS chart) Exclusion Criteria: * Eyes classified as either normal, atypical normal, or keratoconus suspect on the severity grading scheme. * Corneal pachymetry ≤ 400 microns at the thinnest point measured by Pentacam in the eye(s) to be treated when the isotonic riboflavin solution is used or ≤ 300 microns when the hypotonic riboflavin us used, provided that the corneal thickness after treatment with the hypotonic riboflavin solution is \> 400 microns. Corneal pachymetry ≤ 450 microns at the proposed insertion site for the Intacs * Previous ocular condition (other than refractive error) in the eye(s) to be treated that may predispose the eye for future complications * History of corneal disease * History of chemical injury or delayed epithelial healing in the eye(s) to be treated. * Pregnancy (including plan to become pregnant) or lactation during the course of the study * A known sensitivity to study medications * Subjects with nystagmus or any other condition that would prevent a steady gaze during the CXL and Intacs treatment or other diagnostic tests. * Subjects with a current condition that, in the investigator's opinion, would interfere with or prolong epithelial healing.