Intraocular Lens Power Calculations in Keratoconus

Abstract

This review addresses the preoperative challenges encountered while calculating intraocular lens (IOL) power in patients with Keratoconus (KC). Obtaining reliable biometric readings in KC and irregular corneas can be daunting. Achieving the best possible visual outcomes in these patients needs meticulous planning and attention to detail. The history, stability of the disease, the dilemma in keratometry measurements, axial length, and effective lens position are a few challenges that can be encountered while planning cataract surgery in these patients. Another relevant question while planning cataract surgery in KC is the choice of the IOL. Toric IOLs can be useful in fairly regular astigmatism and can help in debulking the astigmatic cylinder. However, the choice largely depends upon contact lens dependency, an irregular ocular surface, and apical corneal scarring. The review aims to outline the challenges faced and how to circumvent them to achieve good postoperative outcomes.