Keratoconus with Cataracts

I have keratoconus. About 15 years, i had a cornea transplant due to this disease.( both Eyes).  It seems keratoconus came back in my eyes and i was told that i have cataracts.

due to my history, am  i at increase risk for more cornea problems if i have cataract surgery?  also is the mutli focus lenses designed for people who have keratoconus( with high level of anstigasim)?

[Michael J Kutryb, MD]

A multifocals is out of the question for this type of case with probable high levels of astigmatism.  Even a toric, astigmatism reducing lens can be problematic in many cases and usually a single vision IOL will be used unless the astigmatism is very regular and reliably stable.  After cataract surgery, you will likely need glasses as you probably do now.  In select cases with very stable corneas, refractive surgery like lasik or prk could be perfomed after cataract surgery but with your keratoconus history that may be out of the question.  If your corneal cells are plentiful and astimatism is not too bad, you should be able to have a very good result provided you are willing to accept glasses post-op.