gms | German Medical Science

Patients who underwent radial keratotomy several years ago, are currently reporting to the ophthalmologist due to worsening of vision associated with age-related cataracts. We present the case of a cataract phacoemulsification with EDOF toric and no toric IOL implantation in a patient with a previous radial keratotomy (RK). RK was performed more than 20 years ago for reason of optical correction of a moderate myopia. Preoperatively nucleus cataract with corneal regular astigmatism was diagnosed in the right eye and nucleus cataract with irregular asymmetrical corneal astigmatism in the left eye. Since the primary visual requirements of the patient were for distance and middle vision and given the corneal tomography data – Holladay equivalent keratometry readings (EKR), a toric EDOF IOL was chosen for implantation in the right eye and non-toric EDOF IOL in the left eye. Lentis Comfort (LS-313 MF15) IOLs were implanted consequently, in both eyes after phacoemulsification. The ASCRS formula was chosen for IOL power calculation because of previous RK. Good vision in both eyes was achieved. Three months postoperatively, the uncorrected distance visual acuity had increased from 1.20 logMAR to 0.0 logMAR in the right eye and from 0.60 logMAR to 0.10 logMAR in the left eye. The uncorrected near visual acuity: 0.50 logMAR in the right eye and 0.10 logMAR in the left eye. Patient was completely satisfied with his visual functioning.

Conclusion: Cataract surgery in patients who underwent RK is challenging for cataract surgeons due to difficulties encountered while choosing IOL power. The non-diffractive EDOF IOL implantation, analysis Holladay EKR report and calculation IOL power according ASCRS formula have demonstrated good three months visual results for cataract treatment after RK.