Effectiveness Of Cararact Surgery In Patients With Non-Progressive Keratoconus
Published 2024 - 42nd Congress of the ESCRS
Reference: PP19.05 | Type: Poster | DOI: 10.82333/njzf-rz45
Authors: Elena Likhorad* 1 , Pavel Beliakouski 1 , Mikalai Pazniak 1 , Aleh Pazniak 1 , Dmitry Abelski 1
1Microsurgery,Eye Microsurgery Center VOKA,Minsk,Belarus
Purpose
To determine the effectiveness of cataract surgery in patients with non-progressive keratoconus
Setting
Eye Microsurgery Сenter VOKA, Minsk, Belarus
Methods
Retrospective analysis of 27 cases of cataract phacoemulsification (CPE) in patients with keratoconus (KC) was performed. The follow-up period ranged from 3 to 46 months. In 1 case CPE with IOL implantation was performed for mature cataracts, in 10 cases for immature cataracts, in 15 cases for initial cataracts and in 1 case for refractive purposes. In 8 cases there was grade 1 K(29,6%), in 13 cases - grade 2 (48.2%), in 6 eyes - grade 3 (22.2%). The target refraction (TR) was emetropia (17 eyes) or low myopia (-2.5) (10 eyes). In 1 case Clareon IOL was implanted; in 26 cases toric IOLs SN6AT3 – SN6AT9 (Alcon, USA).
In calculating the IOL Barrett True K for keratoconus, Kane formula for keratoconus, Holladay 2, SRK-T formulas were used.
Results
Uncorrected distant VA before surgery in a group of emetropia TR: 0,18 ± 0,14, in a group of myopia TR 0,72 ± 0,24. Best corrected VA in all cases 0,53 ± 0,24, refraction sph -6,51 ± 3,07; cyl -2,89 ± 1,32.
As a result of surgical treatment an improvement in the following clinical and functional results was obtained: refraction, uncorrected and best corrected visual acuity. The following results were obtained in 3 months or more after the surgery: uncorrected distant VA in a group of emetropia TR 0,72 ± 0,24, in a group of myopia TR 0,32 ± 0,14. Best corrected VA 0,83 ± 0,13, refraction sph 0,35 ± 0,59 in a group of emetropia TR; refraction sph -2,2 ± 1,04 in a group of myopia TR. Cyl -1,13 ± 0,86 in both groups.
Conclusions
Modern technologies for cataract removal in patients with non-progressive keratoconus can improve functional results.
Barrett True K and Kane Keratoconus formula provide the most accurate results in achieving TR.
The use of toric IOLs in patients with the 1-2 grades of keratoconus compensates astigmatism in most cases; in patients with 3 grade the use of toric IOLs is less predictable and allows to partially compensate the astigmatism.