Cataract surgery in patients with underlying keratoconus: focused review

Abstract

An underlying diagnosis of keratoconus (KC) can complicate cataract surgery. In this study, the results of a focused review of the literature pertaining to cataract surgery in patients with KC are detailed. Topics essential for the appropriate management of this patient population are discussed. First, the individual and shared epidemiology and pathophysiology of cataract and KC are reviewed. Then, the theory and approach to intraocular lens power calculation are discussed, highlighting particularities and pitfalls of this exercise when performed in patients with KC. Finally, several special-although not uncommon-management scenarios and questions are addressed, such as surgical planning in cases where corneal stabilization or tissue replacement interventions are also necessitated.

Cataract Surgery following Corneal Allogenic Intrastromal Ring Segments and Implantable Collamer Lens

“…Currently, all biometry formulas available require axial length and keratometry value (K)_as minimal parameters to evaluate refractive power [9]. Accurate measurements of the axial length is important as keratoconus patients often have deeper anterior chambers and have been observed to have longer axial lengths when compared to individuals without the condition [10]. Additionally, the apex of the cornea is not centrally located, which can lead to unreliable measurement of the visual axis [10].…”

“…Accurate measurements of the axial length is important as keratoconus patients often have deeper anterior chambers and have been observed to have longer axial lengths when compared to individuals without the condition [10]. Additionally, the apex of the cornea is not centrally located, which can lead to unreliable measurement of the visual axis [10]. Several studies have depicted that the more advanced the keratoconus, the less repeatable the keratometry values [9,11].…”