Keratolenticuloplasty: arcuate keratotomy for cataract surgery and astigmatism

Cataract surgery has evolved into a procedure in which pre-existing refractive errors can be corrected simultaneously to improve uncorrected visual acuity following surgery. This paper describes keratolenticuloplasty, a new technique of clear corneal arcuate keratotomy for cataract surgery that corrects pre-existing astigmatic errors at the time of cataract extraction. This technique uses topical anesthesia, a single pair of arcuate corneal incisions placed on the steepest axis of astigmatism, one-step capsulorhexis, hydrodissection, intercapsular phacoemulsification, and injection of an elastic intraocular lens within the capsular bag. The technique has been used in over 1,000 patients with follow-up of 24 months. Uncorrected visual acuity of 20/40 or better with no associated complications was achieved in 96% of patients.