Edof Iol For Bilateral Cataract In Young Patient With Previous Prk

To report a case and surgical results of unknown reason  bilateral cataract in young patient with history of refractive surgery (PRK) seven years ago.

Private ophthalmology practice

A 32-year-old male patient suffered from poor vision on his both eyes. He underwent photorefractive keratectomy PRK surgery for mild myopia + astigmatism about 7  years ago. The PRK procedure was uncomplicated and both eyes was stable with 10/10 visual acuity in both eyes after 3 months of surgery. On routine follow up every 6 months for three years the patient did not suffered from any problem except intermittent dryness managed by lubricant eyedrops. Patient come back on January 2021 complaining from poor viision in both eyes in last six months. With examination the diagnosis was bilateral nuclear cataract. I asked the patient to contact his father and with discussion his father said that he suffered from psychological problem and managed by psychiatrist for more than 2 years. performing full evaluation (VA, BCVA, TONOMETRY, CORNEAL TOMOGRAPHY, OCT, BIOMETRY) The decision was cataract surgery with EDOF toric IOL for both eyes. The refraction was (OD: -6.50 sph -1.75*50) and (OS:-6.25 sph -0.75*98). VA was 0.3 in both eyes with no correction. The challenge was choosing the right IOL power, after doing calculation with Haigis-L formula and Barrett true-k formula we choose +21 D with 1.50 cyl for right eye and +22 D with 1.00 cyl for left eye. After one month of  surgery the refraction was (OD:  -0.25 sph -0.25*80) and (OS:0.00 sph-0.50*67). UCVA was 10/10 in both eyes with good independent glasses VA for near vision with both eyes and the patient was very satisfied.

A history of patient’s refractive surgery procedures will help to avoid refractive «surprises» after cataract surgery. In young patient with refractive surgery history it is better to choose the most glasses independent IOL with less aberrations and halos. Measurements of the posterior corneal surface are mandatory as the corneal refractive index changes. To choose the right IOL power it’s necessary to apply at least two formulas of the third generation (Barrett True-K, Haigis-L… etc).