Cataract surgery considerations in patients with prior history of keratoconus and ectasia. Issue 1 (19th January 2023)

• Record Type: Journal Article
• Authors: Moshirfar, Majid; Ziari, Melody; Ronquillo, Yasmyne C.
• Is Part Of: Current opinion in ophthalmology. Volume 34:Issue 1(2023)
• Page Start: 41
• Page End: 47
• Publication Date: 2023-01-19
• Subjects: biometry -- cataract surgery -- cornea -- intraocular lens -- keratoconus -- keratometry -- pentacam; Ophthalmology -- Periodicals; Eye Diseases -- Indexes; Eye Diseases -- Periodicals; Review Literature -- Indexes; Review Literature -- Periodicals; Vision Disorders -- Indexes; Vision Disorders -- Periodicals; 617.7
• DOI: 10.1097/ICU.0000000000000908
• Languages: English
• ISSNs: 1040-8738

Abstract

Abstract : Purpose of review: Preoperative workup for cataract surgery in patients with keratoconus poses certain challenges, particularly in patients with moderate-to-severe disease. This review aims to outline the appropriate preoperative, intraoperative, and postoperative considerations and provides an algorithm to help guide the workup prior to surgery. Recent findings: A new system for keratoconus progression and staging has been proposed and additional studies comparing intraocular lens (IOL) formulas calculations and biometry devices have been conducted. Summary: Patients with severe keratoconus have unpredictable results and have an increased risk of a hyperopic refraction postoperatively. Although studies have compared IOL calculation formulas, there is no consensus on management. Clinical considerations and an approach to the workup are presented; however, additional studies are required to determine the most appropriate management of cataracts in severe keratoconus.