MICS with toric intraocular lenses in keratoconus: outcomes and predictability analysis of postoperative refraction.

AIMS: To investigate the visual and refractive outcomes, safety, efficacy and stability of cataract surgery in eyes with stable keratoconus.

METHODS: 17 eyes (10 patients) diagnosed as stable keratoconus, aged from 34 to 73 years (56.63 ± 12.47), underwent micro-incision cataract surgery (MICS) followed by implantation of toric intraocular lens (IOL). Seven of them were operated bilaterally and three unilaterally. A complete ophthalmological examination was performed preoperatively and postoperatively. The main outcome measures were: uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry and manifest refraction.

RESULTS: Sphere changed from -1.77 ± 6.57D (-11.00 to 7.00) preoperatively to 0.08 ± 0.79D (-1.25 to 1.75) postoperatively (p=0.211), and cylinder changed from -2.95 ± 1.71D (-7.00 to -0.75) to -1.40 ± 1.13D (-3.25 to 0.00) (p=0.016). UDVA (logMAR) changed from 1.33 ± 0.95 (0.40 to 2.77) to 0.32 ± 0.38 (0.00 to 1.30) (p=0.008) and CDVA (logMAR) changed from 0.32 ± 0.45 (0.01 to 1.77) to 0.20 ± 0.36 (-0.03 to 1.30) (p=0.013). Efficacy and safety indexes were 1.38 ± 0.58 and 1.17 ± 0.66, respectively. Refraction and corneal topography were stable during the follow-up (9.10 ± 5.54 months, 3-15) CONCLUSIONS: MICS surgery using corneal topography data and standard formulas for the calculation of the IOL power is a safe and effective procedure regarding keratometric stability, visual and refractive results.