Cataract Surgery In Eyes With Keratoconus: Making It Possible To Increase The Patient Satisfaction.

Currently, high expectations from surgery and changes in lifestyle have increased the patient's visual demand .The corneal pathologies, such as keratoconus , penetrating keratoplasty, that influence cataract surgery success. 

The aim of this study was to evaluate the visual function outcomes and patient satisfaction after  Extended Depth of Focus (EDOF) IOLs  implantation in patients with stabilized keratoconus.

A prospective study was conducted on the basis of the S. Fyodorov Eye Microsurgery Federal State Institution.

The study included 16 patients (16 eyes) with stabilized keratoconus. All patients underwent cataract surgery using a femtosecond laser (Ziemer FEMTO LDV Z8) with  EDOF IOL Vivity Totic (Alcon) implantation. The IOL was calculated using three calculators (Barrett Toric, ESCRS calculator , including one developed at the S. Fyodorov Institution, which takes into account changes in the anterior and posterior corneal surfaces). Uncorrected visual acuity (5 m), UCVA near (33 mm), and  UCVA intermediate (66 cm) were examined. Among the special methods, keratopachymetry, keratotopography, determination of spatial-contrast sensitivity in conditions of varying degrees of illumination and patient satisfaction were carried out at 1, 3, 6, 12 months.

Clinical and functional results of  EDOF IOL implantation in patients with corneal pathology demonstrate a significant increase (0,7±0.18) in UCVA and BCVA(0,8±0.16) , UCVA at near(0,5±0.19), and intermediate distances(0,6±0.13) . The survey results show that all Visual Function test – 14 values correspond to a high level (89±5)  of subjective assessment of the achieved functional results.

Implantation of the EDOF IOL Vivity Toric can improve visual functions at distance, intermediate distance and near. The results obtained confirm the ability of EDOF IOLs to enhance the adaptation of the patient's visual functions to non-ideal conditions. Therefore, we can speculate on the potential benefit of using EDOFs over monofocals in cases where IOL