Cataract Surgery in a Patient with Keratoconus: A Refractive Challenge
Keywords:
keratoconus; cataract surgery; formulas for calculating intraocular lens power.Abstract
Cataract surgery is a safe procedure and is currently considered refractive surgery, but in complex cases, such as patients with keratoconus, it is considered a challenge, even for experienced surgeons. Keratoconus is a bilateral disease with an asymmetric progression, characterized by the progressive protrusion and thinning of the corneal apex. Cataract surgery in patients with keratoconus presents a challenge for the surgeon at all stages: pre-surgical, intraoperative, and postoperative. Refractive outcomes are difficult to predict due to the complexity of intraocular lens (IOL) calculation. We present the case of a patient with keratoconus who underwent cataract surgery, despite the inherent challenges of IOL calculation in these cases. The IOL calculation was evaluated using various formulas, but it was not possible to perform it during the same surgical procedure. A secondary iris-fixated implant was planned, but ultimately, the patient remained aphakic and very satisfied with her vision.
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