Clinical Profile Of Cataract Surgery In Patients With Corneal Pathologies: A Retrospective Study

Abstract

Background: Cataracts remain the world's leading cause of treatable blindness, while corneal opacity represents the fifth leading cause of blindness globally. Coexisting cataracts and corneal pathologies present unique surgical challenges, with variable visual outcomes reported. This study aimed to determine the role of preoperative planning, intraoperative modifications, and postoperative visual outcomes in patients undergoing cataract surgery with concurrent corneal pathologies.

Methods: A retrospective study of 30 patients with cataract and corneal pathology (August–October 2025) assessed visual outcomes after cataract surgery. Preoperative evaluations included visual acuity, AS-OCT, specular microscopy, and intraocular pressure. Postoperative visual outcomes and complications were analyzed using paired t-tests for BCVA changes and Pearson correlation to assess the relationship between corneal opacity severity and visual improvement.

Results: Mean age was 68.2 ± 11.5 years. Mean BCVA improved significantly from 1.45 ± 0.65 logMAR preoperatively to 0.94 ± 0.55 logMAR postoperatively (p < 0.001). Postoperative complications included mild corneal edema (13.3%), striate keratitis (10%), and reactivation of pre-existing corneal pathology (6.7%). A significant inverse correlation was found between corneal opacity severity and postoperative visual improvement (r = -0.782, p < 0.001).

Conclusion: Small incision cataract surgery with PCIOL implantation is a safe and effective interim procedure in carefully selected patients with coexisting cataracts and corneal pathologies, providing meaningful visual rehabilitation when corneal transplantation is not immediately feasible. ASOCT proves valuable in preoperative assessment and prediction of visual outcomes.