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

Currently, patient satisfaction with the results of cataract surgery is of great importance, including in patients with stabilized keratoconus after crosslinking and after implantation corneal ring segments with subsequent crosslinking. And the choice of IOLs in these patients plays a key role.

The purpose of this study was to evaluate and compare the results of visual functions and patient satisfaction after implantation of an extended depth of field (EDOF) IOL in cataract patients with stabilized keratoconus and without concomitant pathology.

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 cataract and stabilized keratoconus after crosslinking and after implantation corneal ring segments with subsequent crosslinking and 20 patients (20 eyes) with cataract without concomitant pathology. All patients underwent cataract removal surgery using a femtosecond laser with implantation of an EDOF toric IOL. IOL calculation was performed using three calculators, including the one developed at the S. F. Fedorov Eye Microsurgery Federal State Institution, which takes into account changes in the anterior and posterior surfaces of the cornea. UDVA (5 m), UNVA (33 mm) and UIVA (66 cm) were studied using tables ETDRS and an original interactive computer program for visual acuity management. 

The clinical and functional results of EDOF IOL implantation in patients with stabilized keratoconus (0.72±0.05) demonstrate an insignificant difference with the results of patients with cataracts without concomitant pathology (0.85±0.04, p=0.03), who were implanted with EDOF IOL. At the same time, uncorrected near visual acuity (33 mm) in patients with keratoconus is higher (0.70±0.05) than in patients without concomitant pathology (0.56±0.05). The survey results show that all values of the visual function test - 14 correspond to a high level (89±5) of subjective assessment of the achieved functional results.

Implantation of EDOF IOLs can improve visual functions at a distance, at an intermediate distance and at a near distance. The obtained results confirm the ability of EDOF IOLs to improve the adaptation of the patient's visual functions to non-ideal conditions. Achieving improved near vision in patients with keratoconus after implantation of edof lenses requires further study.