Visual Outcomes In Patients With Corneal Ectasia After Cataract Surgery

To observe and analyse the visual outcome of patients with corneal ectasia undergoing cataract surgery.

This was a consecutive retrospective case series of patients from the L.V. Prasad Eye Institute, India from 2014 to 2023.

Data of all patients, diagnosed with Corneal ectasia clinically and on Corneal Tomography, who underwent cataract surgery was analysed. Preoperatively, the sex, age, grade of cataract, best-corrected visual acuity (BCVA), refractive error and Contact lens (CL) use was documented.  Biometry was performed by using 2 or more optical biometers. Clear corneal phacoemulsification with foldable intraocular lens was performed in all cases.  Patients were assessed at one and half month’s post-surgery. Best-corrected visual acuity (BCVA), visual improvement and contact lens requirement were assessed. The difference between spherical equivalent and desired refraction was evaluated and the mean absolute error were expressed as median and range.

Fifty-four eyes from forty-eight patients were evaluated. Mean age of patients was fifty-one ± twelve years.In the KC group twenty-three eyes had monofocal IOL implantation and 9 eyes had Toric IOL implantation, the improvement in BCVA was from logMar 1.6(0.1, 2.2) to logMar 0.2(0, 1.6) and logMar 0.8(0.6, 0.8) to logMar 0.1(0.1, 0.1) respectively. In the PMCD group four eyes underwent Toric IOL implantation with an improvement from logMar 0.7(0.5, 2.2) to logMar 0.2(0, 0.3) . Four eyes with KG showed an improvement of logMar 0.7(0.4,1.2) to logMar 0.5(0.2,0.8)  and four eyes with TMCD showed an improvement of logMar 0.7(0.3,1.2) to logMar 0.2(0,0.4).The Mean prediction error was maximum in the Keratoglobus eyes and least in eyes with TMCD.

Our study concluded that eyes mild-moderate cases of KC, PMCD and TMCD had good postoperative results after cataract surgery while eyes with severe KC and KG showed unpredictable results. Toric IOL implantation was suitable option in eyes with Mild KC and PMCD. This was one-of-a-kind study attempting to compare the visual outcomes in different types of corneal ectasia post cataract surgery.