title: Corneal collagen cross-linking followed by phacoemulsification with IOL implantation for progressive keratoconus associated with high myopia and cataract.
abstract: OBJECTIVE
  To evaluate the visual and topographic outcomes of a two-stage approach treatment for progressive keratoconus (KC) associated with high myopia and cataract.
  
  
  METHODS
  Two patients, a 50-year-old man and a 54-year-old woman with high myopia (spherical equivalent greater than -10D), cataract, and progressive KC with poor spectacle-corrected vision and contact lens intolerance underwent a 2-stage approach treatment: first corneal collagen cross-linking (CXL) followed after at least 6 months by phacoemulsification with intraocular lens (IOL) implantation in both eyes.
  
  
  RESULTS
  In both patients after a mean follow-up of 3.5 years (from 2 to 4) uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and corneal topography pattern improved in both eyes, and the patients were satisfied with the visual improvement and happy with tolerable glasses.
  
  
  CONCLUSIONS
  This 2-stage approach reported no complications and was effective in improving visual acuity and corneal patterns in patients with high myopia, cataract, and progressive KC.
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnology, "Sapienza" University of Rome, Latina, Italy, leopoldo.spadea@uniroma1.it.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Spadea
authors.forename: Serena
authors.initials: S
authors.lastname: Salvatore
authors.forename: Francesca
authors.initials: F
authors.lastname: Verboschi
authors.forename: Enzo Maria
authors.initials: EM
authors.lastname: Vingolo
mesh_terms: D002386:Cataract / Q000503:physiopathology; D003094:Collagen / Q000378:metabolism; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000601:surgery*; D018918:Phacoemulsification / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen