Keratoconus cornea treatment prior to cataract surgery

[Robertkeen54]

Age 69 male have stable Keratoconus for 44 years, have cataracts
Haven’t had cross linking (cxl) My steep k is 52.6 flat K 49.5
My high myopia calc to -5 depending on the A constant of the lens
Question should I have cxl done before cataract surgery not to stabilize but to flatten my k ?
score to qualify for better and maybe toric lens? My goal is a Plano lens with 2 diopters of regular astigmatism
Which means I would need to be closer to 50 from 52.6 steep k

[John C Hagan III, MD, FACS, FAAO]

Robert you would need to consult an Eye MD opthalmologist with specialty in cornea and refractive surgery. CXL is normally done on younger patients to prevent steepening. It is not especially useful in older people with stable K-conus to flatten the cornea. I doubt if that is useful at all.  By seeing a cornea Eye MD they can do a topography to see how much irregular astigmatism you have, you might be a good candidate for a toric (astigmatic) IOL or the new light adjusted IOL.  Find the most highly regarded corneal /refractive surgeon in your area for your evaluation.