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Cataract surgery after radial keratotomy and your management of anisiometropia

Poster Details

First Author: L.Pucci BRAZIL

Co Author(s):    A. Binda   G. Junior   L. Duarte   M. Siqueira           

Abstract Details


Generate options on the management of anisiometropia after cataract surgery, in patients with corneal aberrations originating from radial keratotomy.




53 years old man, with history of radial keratotomy in both eyes. Referred for cataract surgery in right eye (OD) , after cataract surgery in other hospital. Visual acuity (VA) with best correction OD : Count Fingers 2 meters ; left eye (OS): 20/40(-2) (�,50 D Spherical ) . Biomicroscopy : OD : Inferior corneal opacity, nuclear cataract 4 . OS: pseudophakic , capsular bag Intra Ocular Lens (IOL) . Retinography demonstrates Staphyloma in both eyes. Pre operative discussion: IOL explantation OS ? Attempt to contact lens on OS ? Cataract surgery in OD first approach ?


Surgical approach on OD, and later, management on OS. Axial Length (AL) : 32.01mm (A-scan measurement) , IOL power calculated based on Haigis (fourth generation) formula with residual -1,50 D spherical equivalent refraction, monofocal three-Piece IOL (�,00D power lens) . Postoperative visual acuity OD : 20/30 (-1,50 D Spherical ) . OS management: 1st option : IOL explantation? 2�Â�° Rigid Contact Lens (RCL) fitting ? Reverse Curve RCL : both eyes: 34,00D /42,00D plano 11,4mm. Well fitting on corneal biomicroscopy . Visual acuity OD: 20/30 (-1,50 D Spherical ), OS : 20/20(-1) (�,50D Spherical ) .


Anisiometropia after cataract surgery is a complication related to biometric errors. We outline some possible solutions when we are faced with this type of problem: 1st : IOL explant (greater action on anisiometropia) , 2nd : adaptation of RCL (acts on anisiometropia and corneal aberration) . For the patient in question , the second option was more adequate, which does not mean to be a rule and should be extended to all similar cases . The individualization of each case and patient satisfaction must always be in the foreground .

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