Case Reports

IOL Calculation for complete cataract after radial keratotomy in a patient with different biometrics indicators

Case Report Details

First Author: N.Volkova RUSSIA

Co Author(s):                        

Abstract Details

Purpose:

Present the results of IOL implantation in a patient with complete cataract and altered cornea after radial keratotomy (RK).

Setting:

The combination of complete cataracts with changes in corneal topography due to RK complicates the accuracy of calculating IOL optical strength. In addition, a step-by-step algorithm for calculating IOL in patients with cataracts, complicated RK requires a personalized approach.

Report of Case:

A 62-year-old patient complained of low visual acuity. The diagnosis: complete complicated cataract OD, incomplete complicated cataract OS, condition after RK OU. Keratotopography (Pentacam, Oculus) was performed with the programs Refractive, Holladay ECR Detail Report, Fourier-Analysis. IOL-Master and on-line calculator were used to calculate IOL. OD optical biometry is not possible, according to ultrasound the length: 26.24 mm; keratometry 31.48 D axis 74°, 32.38 D axis 164°, cyl -1.35 ax 74°. According to keratotopography-induced irregular astigmatism. It was decided to implant an aspherical monofocal IOL.

Conclusion/Take Home Message:

IOL implantation was necessary (+) 26D (deviation was from 25 to 27D). But according to data of 1992 before radial keratotomy biometrics OD 24.97 mm (!); keratometry 43.25 D axis 147°, 43.62 D axis 57°, cyl -0.37 ax 147°. It was necessary to implant IOL (+) 16D (no deviation according to formulas). Difference between keratometry before and after RK 13D. Optical strength of desired IOL was +29D. Difference between biometrics of 1992 and 2018 was 1.27 mm, difference in planned IOL diopter 3D. What to do? It was decided to implant IOL +29D. The Snellen visual acuity was 0.9.

Financial Disclosure:

None