title: MICS with toric intraocular lenses in keratoconus: outcomes and predictability analysis of postoperative refraction.
abstract: OBJECTIVE
  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.
authors.affiliation: Keratoconus Unit, Vissum Corporacion Alicante, , Alicante, Spain.
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.forename: Pablo
authors.initials: P
authors.lastname: Peña-García
authors.forename: Fidan
authors.initials: F
authors.lastname: Abdulla Guliyeva
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Soria
authors.forename: Ghassam
authors.initials: G
authors.lastname: Zein
authors.forename: Sabat K
authors.initials: SK
authors.lastname: Abu-Mustafa
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000150:complications* / Q000175:diagnosis; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000150:complications* / Q000175:diagnosis; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011184:Postoperative Period; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
keywords: Cornea; Degeneration; Pathology