Cataract and progressive keratoconus: solutions?

Session Details

Session Title: Cataract Surgery Special Cases II

Session Date/Time: Monday 15/09/2014 | 16:30-18:30

Paper Time: 16:36

Venue: Auditorium

First Author: : E.Gurmizov RUSSIA

Co Author(s): :    K. Pershin              

Abstract Details

Purpose:

Combination of a cataract and progressive keratokonus is a rather seldom rare condition with no generally accepted standards of management. Our purpose was to combine phacoemulsification with subsequent corneal segments implantation for patients with cataract and progressive keratokonus of the I-II stages by Amsler, who can't use hard contact lenses for various reason.

Setting:

Ophthalmologic clinic “EXCIMER”, St. Petersburg, Russia.

Methods:

Five eyes of 4 patients with cataracts of various degrees of maturity and density in combination with progressive keratokonus of the first and second stages were included. Mean age of patients was 42 years. Mean uncorrected visual acuity (UCVA) was 2/20, and the best corrected visual acuity (BCVA) was 8/20. Surgical technique consisted of two stages. First, Femto-laser assisted formation of tunnels for corneal sigments (CS) and subsequent microincision cataract surgery, implanting monofocal aspherical IOLs without any toric component were performed. A week later basing on keratotopografy results CSs were implanted. And then corneal crosslinking (CXL) was made. In one case additional sulcoflex IOL was used.

Results:

In 60% of cases, final UCVA was 12/20 and above. In 80% of cases, final BCVA was 16/20-20/20. Neither during treatment nor within 6 months after surgery any complications were observed.

Conclusions:

Target refraction at calculation of IOLs was myopia of 2-2,5 diopters. That was essential for creation of a 'safety margin' in postoperative refraction. That can be easily corrected by the implantation of CSs. Implantation of CSs with CXL allows to delay or even completely eliminate the need for a keratoplasty. Combination of phacoemulsification and subsequent CSs and CXL implantation for patients with cataract and progressive keratokonus of the I-II stages proved to be safe and allowed predicted refractive outcomes.

Financial Interest:

NONE