Corneal Topography for Intraocular Lens Selection in Refractive Cataract Surgery

The purpose of this review is to evaluate the usefulness of corneal topography to select premium intraocular lenses (IOLs), including aspherical IOLs, toric IOLs, and multifocal IOLs, in refractive cataract surgery. Corneal topography can detect corneal regular astigmatism, corneal irregular astigmatism (higher-order aberrations [HOAs]) including spherical aberration, and corneal shape abnormalities after corneal refractive surgery. Surgeons can explain to the patients with significant corneal HOAs about its effect on postoperative visual function before surgery. Multifocal IOLs should not be selected for such eyes. For eyes with abnormal corneal shape, appropriate IOL power calculation formulae can be applied. In the case of toric IOLs, regular astigmatism and corneal HOAs should be checked. Before implanting an aspheric IOL, it is ideal to confirm spherical aberration of the cornea is not below the normal range. Because corneal HOAs, abnormal corneal shape after corneal refractive surgery, corneal regular astigmatism, and corneal spherical aberration increase postoperative refractive errors and poor vision quality with premium IOLs, corneal topography before cataract surgery is helpful in screening patients who are not appropriate candidates for premium IOLs.