Keratoconus here...since 2009

We use to live in a rural location like you and would drive 3 hours to a cornea specialist, he was worth the effort.
My husband has keratoconus with acute hydrops, which means the cornea rapidly thins and ruptures making you blind in that eye. He has had 7 cornea transplants since the early 70's. Back then surgery was brutal, they popped your eye out of the socket to operate. Surgery now is a lot simpler and less traumatic, they leave some of the edge of the cornea on which they graft the new cornea so they get a better outcome.
Before his surgeries he wore gas permeable hard contact lenses which evened out the severe astigmatisms. The astigmatisms were so severe the contact lenses would fall out if he blinked too hard or the wind caught his eye just right. We spent many hours looking for those lost contacts lenses.
After the last surgery he was able to finally be fitted with glasses and is doing well, the grafted corneas are doing well (knock on wood). He has had so many transplants I am not sure how successful any future one would be.
You might ask why so many surgeries? Sometimes the cornea cells start to enlarge to such an extent the cornea graft will fail, one time he got an infection right after surgery so had to have a redo when that graft failed. One time an inexperienced doctor recommended the steroid drops be discontinued, the cornea immediately rejected.
If you ever get a transplant be advised that flu and covid vaccines can cause a cornea rejection so you need to start a prednisolone eye drop protocol before and after the vaccination.
So if you have any questions ask away!