Outcomes of a Management Strategy in Eyes with Corneal Irregularity and Cataract

Abstract

Purpose. To evaluate the outcomes of a management strategy in patients with irregular corneas and cataract. Methods. Six eyes of four patients presented for cataract surgery with irregular corneas following corneal refractive surgery. Topoguided ablation regularised the cornea, followed by phacoemulsification and intraocular lens implantation. Zonal keratometric coefficient of variation (ZKCV) measured structural changes and visual quality metrics measured functional improvement. Results. The mean duration after corneal refractive surgery was 7.83 ± 2.40 years. The logmar uncorrected distance visual acuity (0.67 ± 0.25) and the corrected distance visual acuity (0.38 ± 0.20) improved to 0.34 ± 0.14 and 0.18 ± 0.10, respectively. The changes in the standard deviations of the zonal keratometry values and the ZKCV were statistically significant in the 2, 3, and 4 mm zones. The changes in the Strehl ratio (ANOVA p = 0.043) were also statistically significant. Conclusions. Corneal regularisation followed by phacoemulsification resulted in lower residual refractive error with improved visual quality metrics. This strategy is a viable option in patients with symptomatic cataracts and irregular corneas.

The SWISS IOL Technique (Small-Width Incision Scleral Suture): A Mini-Invasive Technique

“…Another challenge is the refraction target, which must be improved as we experienced a myopic shift in all cases. This could be partially explained by the irregular shape of the traumatized cornea of patients 2 and 3 [ 26 ].…”

Equivalent keratometer reading para cálculo biométrico em córneas assimétricas: série de casos

“…Ablação irregular, zona óptica pequena ou descentrada e trauma com grandes cicatrizes são exemplos de alterações que causam aberrações corneanas de alta ordem, e não há uma fórmula biométrica que seja reconhecida universalmente com unanimidade para esses casos. (3) Utilizar a ceratometria mensurada erroneamente pós-refrativa pode levar a valores hipoestimados da dioptria (D) da LIO, o que resulta em hipermetropia pós-operatória e gera insatisfação e frustração ao paciente, que geralmente é mais exigente com as expectativas de visão. (4) Mensurar corretamente o poder corneano, e não só a ceratometria, é essencial, para obter o cálculo biométrico adequado.…”