Keratoconus must be diagnosed in advance. Case report and discussion of the diagnostic approach

Abstract

Performing cataract surgery on a patient with keratoconus is not uncommon. Cataract surgery for such patients does require some additional testing and consideration for the best visual outcomes. Choosing the appropriate lens and lens power can be more challenging. Most patients with keratoconus have high negative spherical aberration and implantation of multifocal intraocular lenses (IOLs) will result in loss of contrast sensitivity associated with these lenses which will be magnified by the corneal irregularity. Also, decentration of IOL relative to the apex of the cone will induce coma and decrease the quality of vision. Our goal was to describe the result after implantation of multifocal intraocular lens in a patient with forme fruste keratoconus and to show that the preoperative selection of an appropriate IOL in such patient is the key for better visual function.