Scleral Lens Power Surprise After Cataract Surgery In Patients With Irregular Corneas
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT610 | Type: Free paper | DOI: 10.82333/hnd5-sy37
Authors: Dr Nienke Soeters* 1 , Mrs Dieuwke van Ooik 1 , Mr Mark Holtmann 1 , Dr Korine van Dijk 1 , Dr Esther-Simone Visser 1 , A/Prof. Mor Dickman 2
1Visser Contactlenzen,Nijmegen,Netherlands, 2Ophthalmology,University Medical Center Utrecht,Utrecht,Netherlands
Purpose
Intraocular lens (IOL) calculation for cataract surgery is complicated in irregular corneas due to various reasons. In scleral lens wear, the (negative) tear lens power must also be accounted for to achieve a satisfied outcome. This study describes significant differences in scleral lens power before and after cataract surgery in patients with irregular corneas.
Setting
A retrospective study among patients wearing scleral lenses at a specialized contact lens center in the Netherlands.
Methods
This study analyzed data from scleral lens patients with irregular corneas who underwent cataract surgery and subsequently required a marked change in scleral lens power. Demographics, scleral lens fitting and power (spherical equivalent [SE], diopters [D]) before and after surgery, and the indication for scleral lens wear were evaluated.
Results
Of 26 patients (48% female), scleral lenses of 34 eyes were analyzed. Median age at the time of the surgery was 68.5 years (range 39 to 76) and 53% had surgery in OD. The scleral lens indication was irregular astigmatism due to keratoconus (79%), keratoplasty (15%) and other reasons (6%). Mean scleral lens SE changed from +0.51D (SD 2.30, range -3 to +7) pre-op to +9.8D (SD 3.9, range +2.5 to +21.5) post-op, P<0.001.
Conclusions
Despite advances in IOL power calculations for irregular corneas, scleral lenses showed a remarkable pre- to post hyperopic shift after cataract surgery, which may lead to anisometropia, aniseikonia and hypoxia (due to increased lens thickness). Therefore, when calculating IOL power in patients with irregular corneas who are expected to remain lens-dependent after surgery, the ongoing use of a scleral lens should be considered, as it alters the overall optical system of the eye.