Cataract Surgery in Combination with Corneal Surgery

Cataract extraction (CE) is currently one of the most commonly performed surgeries worldwide, since it is a quick procedure that can be performed under topical or local anaesthesia, and since it leads to rapid visual recovery in most cases with significant improvement in vision and increased spectacle independence. With the increasing number of CE performed, surgeons are encountering more often patients with concurrent corneal diseases, including keratoconus (KC), corneal opacities/scars or corneal degenerations, and different congenital abnormalities or corneal dystrophies, with Fuchs' endothelial corneal dystrophy (FECD) being the most common. Conversely, central corneal transplant procedures and cataract surgery are one of the most frequent combinations that the corneal surgeons have to deal with. Another important aspect is the association between corneal disease and the earlier onset of cataract, as occurs in KC, in infectious keratitis and herpetic eye disease (HED), and in eyes with corneal grafts. Importantly, cataract surgery has the potential to contribute to the progression of pre-existing corneal disease, and similarly, corneal disease can limit surgical techniques of CE and may be the cause of poor outcomes after CE.