Current concepts in the management of cataract with keratoconus.

Publisher: Medknow Publications Country of Publication: India NLM ID: 0405376 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1998-3689 (Electronic) Linking ISSN: 03014738 NLM ISO Abbreviation: Indian J Ophthalmol Subsets: MEDLINE

Publication: Mumbai : Medknow Publications
Original Publication: Bombay : All-India Ophthalmological Society

Keratoconus*/complications ; Keratoconus*/diagnosis ; Keratoconus*/surgery ; Lenses, Intraocular* ; Cataract*/complications ; Astigmatism*/surgery; Humans ; Lens Implantation, Intraocular/methods ; Visual Acuity ; Refraction, Ocular

This review analyzed all pertinent articles on keratoconus (KCN) and cataract surgery. It covers preoperative planning, intraoperative considerations, and postoperative management, with the aim of providing a simplified overview of treating such patients. Preoperatively, the use of corneal cross-linking, intrastromal corneal ring segments, and topo-guided corneal treatments can help stabilize the cornea and improve the accuracy of biometric measurements. It is important to consider the advantages and disadvantages of traditional techniques such as penetrating keratoplasty and deep anterior lamellar keratoplasty, as well as newer stromal augmentation techniques, to choose the most appropriate surgical approach. Obtaining reliable measurements can be difficult, especially in the advanced stages of the disease. The choice between toric and monofocal intraocular lenses (IOLs) should be carefully evaluated. Monofocal IOLs are a better choice in patients with advanced disease, and toric lenses can be used in mild and stable KCN. Intraoperatively, the use of a rigid gas permeable (RGP) lens can overcome the challenge of image distortion and loss of visual perspective. Postoperatively, patients may need updated RGP or scleral lenses to correct the corneal irregular astigmatism. A thorough preoperative planning is crucial for good surgical outcomes, and patients need to be informed regarding potential postoperative surprises. In conclusion, managing cataracts in KCN patients presents a range of challenges, and a comprehensive approach is essential to achieve favorable surgical outcomes.
(Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

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Date Created: 20240223 Date Completed: 20240329 Latest Revision: 20240607

20240607

PMC11149527

10.4103/IJO.IJO_1241_23

38389251