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Fixed dilated pupilla is an uncommon but well-known complication of keratoplasty. The exact mechanism remains unknown but postoperative high IOP seems to be an important risk factor following complicated DALK. Rise in IOP during the management of complications following DALK related to DM was found to be important in the development of FDP in this series.

This small sample was not able to demonstrate a difference between the two types of lenses with regard to the variables examined, and further larger trials would be required to determine if differences truly exist or not. However, clinicians may still consider patient comfort and vision in selecting the lens type in patients with keratoconus.

Treatment of post-DALK keratoconus patients with LASIK to correct manifest refraction error seems to be a viable option.

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No author has a financial or proprietary interest in any material or method mentioned.

BackgroundTo evaluate the clinical outcomes after the implantation of a new trifocal diffractive intraocular lens (IOL) combined with Enhanced depth of focus (EDOF) technology.MethodsThe study enrolled 80 eyes of 40 patients who underwent cataract surgery with bilateral implantation of a diffractive trifocal IOL (Reviol Tri-ED) designed with a combination of enhanced depth of focus. Mean age was 52.09 ± 11.32 years (range from 45 to 70 years). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), corrected intermediate visual acuity (CIVA), uncorrected near visual acuity (UNVA), corrected near visual acuity (CNVA), keratometry (K), and manifest refraction spherical equivalent (MRSE) were evaluated pre- and postoperatively. The contrast sensitivity, defocus curves, and a questionnaire evaluating individual satisfaction were also estimated.ResultsThere was a significant improvement in UDVA, CDVA, UNVA, CNVA, CIVA postoperatively. The defocus curve confirmed good visual acuity also in the intermediate distance. The postoperative MRSE was ranged from −0.75 to 0.75 diopters. Contrast sensitivity also significantly improved postoperatively. The patient satisfaction was high.ConclusionThe new trifocal EDOF IOL provides visual improvement for far, intermediate, and near distances with a high level of visual quality and patient satisfaction.