Long-Term Results Of Refractometry In Patients After Cataract Phacoemulsification And Penetrating Keratoplasty By Calculating The Optical Power Of Intraocular Lenses Using A Pentacam Axl Keratotopograph

To analyze postoperative clinical refraction (corneal astgimatism and spheroequivalent) after ultrasonic cataract emulsification in patients after penetraiting keratoplasty and to evaluate the effectiveness of various approaches to IOL calculation.

44 eyes of 44 patients with complicated cataract who had previously undergone penetrating keratoplasty  were operatad in Dnepropetrovsk Regional Clinical Ophthalmological Hospital for the period 2021-2023. 

Our patients were randomized into 2 equal groupes of 22 eyes according the method of IOL caclulation: main group with IOL calculation using Oculus Pentacam AXL keratotopograph, in which the keratometry data were taken from the Holliday EKR Detail Report zone 3 mm and a control group with IOL  calculation using  HAAG STREIT Lenstar LS 900 in the standard method Barrett formula. All patients underwent monofocal TECNIS Eyhance IOL implantation. Phacoemulsification was performed according to the standard technique through a 2.75 mm incision using the Stellaris device (B&L, USA).

All of the corneal sutures were removed prior the cataract surgery. We asessed refractometry data measured by Reichert RK500 autorefractometer before cataract surgery and a 1 month  after surgery. The value of astigmatism before surgery averaged 3.5 D and spherical equivalent - myopia, amounted to 4.2D (there was no statistical difference in both groups). 

One month after the operation in the main group the corneal astigmatism (М±SD)  was 2.721 ±1.225 D, spherical equivalent - myopia 3.267 ±2.651 D,  in the control group the corneal astigmatism was 3.032 ±2.031 D, spherical equivalent - myopia 4.354 ±2.864 D.

The value of corenal astigmatism and myopic spherical equivalent in the main groupe in one month after cataract curgery is a significantly less than in the control group (p<0.05). Thus, due to a more accurate calculation of the IOL optical power we recommend to use the keratometry parameters measured by Oculus Pentacam AXL in the 3 mm zone of the  Holliday EKR Detail Report map in cataract surgery in patients after penetrating keratoplasty.