International Journal of Keratoconus and Ectatic Corneal Diseases

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VOLUME 7 , ISSUE 2 ( July-December, 2018 ) > List of Articles

CASE REPORT

Importance of Screening for Ectatic Corneal Disease Prior to Multifocal Intraocular Lens

Ramon J Hallal Jr, Renato Ambrósio

Keywords : Cataract surgery, Screening, Subclinical keratoconus

Citation Information : Hallal Jr RJ, Ambrósio R. Importance of Screening for Ectatic Corneal Disease Prior to Multifocal Intraocular Lens. Int J Kerat Ect Cor Dis 2018; 7 (2):128-133.

DOI: 10.5005/jp-journals-10025-1169

License: CC BY-NC 4.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: This article reports the case of a patient with severe symptoms related to bad quality of vision after toric multifocal intraocular lens (IOL) that was diagnosed with mild keratoconus. Materials and methods: To present a case report and prospectively review of the literature, considering the relevance of screening ectaticconreal disease prior to refractive cataract (or lens) surgery. Results: The patient was dissatisfied, seeking a second opinion after the implantation of a toric multifocal IOL in the left eye. The IOL was properly centered and surgery had no complications. The preoperative refraction was −4.00 − 1.50 × 160, giving 20/40. Patient denied any history of keratoconus or transplant in his family. After cataract surgery, uncorrected distance vision acuity (UDVA) was 20/60, and J4 for near. Manifest refraction was + 2.00 − 0.50 × 130, giving 20/30. Corneal topography, tomography, and biomechanical assessments indicated the diagnosis of mild keratoconus. The patient was advised for IOL exchange, which was successfully done for a monofocal aspheric IOL. The patient was satisfied with the final result, presenting a final UDVA of 20/25, J3, and manifest refraction of +0.75 − 0.50 × 105, giving 20/20. Conclusion: Screening for corneal abnormalities including ectatic corneal disease is fundamental prior to the indication of a premium lens. Advanced corneal imaging plays a fundamental role to help select candidates for multifocal IOLs, as for individualized planning of refractive cataract surgery.


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