Cataract Surgery with Irregular Corneas
Irregular corneas can throw a wrench into one of the most common, successful, and safest procedures throughout the United States: cataract surgery. Happy patients are ever present thanks to advances in lens design and preoperative refractive calculations. But there are challenges with patients who present irregular corneas, which can lead to cataract surgery complications.
Irregular corneas are considered either obstructed, which means a scar in the visual axis is occluding the patient’s view, or distorted, which means the shape of the cornea is irregular.
Surgeons must figure out what sort of asymmetry is present in the patient’s eye before they can perform a successful surgery. By mapping the cornea, surgeons can closely examine the surface to reduce adverse outcomes.
Irregular astigmatism can result from damage to the cornea due to an infectious or inflammatory process that affects the shape. Ocular surface disease is the most common form of corneal irregularity, including tear film instability and dry eye disease. Dry eyes can dramatically affect refractive outcomes in patients. Other typical origins of irregular corneas include keratoconus, anterior basement membrane dystrophy, and Salzmann’s nodular degeneration. In patients with these conditions, the surgeon will need to see improvement on a topography prior to lens selection and surgery.
In specific cases for patients with regular astigmatism, the solution can be simple: pick out a toric lens. Unfortunately, this is not an option for many corneal disease patients. Scleral lenses are an option for patients who have irregular astigmatism. These come in both hard and soft forms, and a newer option such as the Prose device, which boasts more specific patient customization.
Before the patient can have cataract surgery, treatments for corneal issues should be addressed and fully healed. If any of the underlying issues (dry eye, for example) return, a more intense regimen is administered to ensure the disease turns around more quickly.
Zen Eye Institute offers the most advanced technology available to provide personalized and extraordinary care to our patients. Whether your goal is to maintain or improve your natural vision, we are here to help you.