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Surgical approach in cataract surgery with corneal ectasias

Poster Details

First Author: F.March de Ribot SPAIN

Co Author(s):    L. Tapia   E. Fernández           

Abstract Details



Purpose:

At present there are case reports, but there is insufficient experience with the use of toric intraocular lenses in patients with keratoconus. The purpose of this study is to report our experience with toric IOLs in patients with keratoconus.

Setting:

Anterior Segment Department at the hospital Asociación para Evitar la Ceguera en México (Mexico City).

Methods:

Interventional study of 10 eyes of 7 patients with diagnosis of stable keratoconus by topography and cataract extraction with toric IOL implantation (SN60T Alcon). Complete preoperative ophthalmic evaluation including refraction was performed. The IOL power calculation was done by interpherometry or ultrasonography depending on the case and posteriorly introducing the data to the acrysoftoriccalculator in order to get the minimal residual spherical equivalent. Phacoemulsification was performed in all cases by only one surgeon with the conventional technique using 2.2 mm corneal incisions. A one-year follow up was made after the surgery performing full examinations including refraction at all visits.

Results:

The results of the study revealed a mean age of 64.6 y/o (range: 46-86 y/o), mean IOL spherical power calculated of 14.5 D (range: 8-17 D) and mean IOL toric power of T6.5 (range: T3-T9). The visual acuity before and after surgery was LogMAR 1.025 (range: 0.3-1.5) equivalent to 20/200 and 0.186 (range: 0.1-0.2) equivalent to 20/30. The spherical equivalent before and after surgery was 6.375 D (range: 2-13.75 D) and 1.25 D (range: 1-1.5 D). The differences were statistically significant. The average keratometry before and after surgery were 46.32D (range: 44 -47.5D) and 46.5D (range: 44.25-48D), p 0.38.

Conclusions:

The use of toric intraocular lenses is an option for patients with stable keratoconus and cataract. In these patients have to be assessed the resulting impact of distortions and aberrations. In our study the visual acuity and refractive errors improved significantly and the cornea remained stable after a year. FINANCIAL INTEREST: NONE

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