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Purpose: To establish a consensus in the Egyptian literature on the management of keratoconus (KC) and cataract in the same eye.
Methods: An Egyptian research team, including 42 KC experts, met to develop a protocol for the management of KC in Egypt. In three scientific meetings, the Egyptian Protocol for Keratoconus (EPK) group focused on the diagnosis and treatment of KC in Egypt. In panels and debates, they discussed procedures to treat coexisting cataract and KC in the same eye. Many experts in the EPK group agreed on the term KC-Plus to refer to KC and cataract in the same eye. The experts then participated in Delphi-style rounds of questionnaires to define this new term.
Results: Thirty-two (76.2%) of the 42 participants who participated in the Delphi-style rounds of questionnaires agreed on the definition of KC-Plus as a term that described the coexistence of cataract and KC in the one eye. The participants agreed on the need for a fourth face-to-face meeting of the EPK group.
Conclusion: Cataract and KC in one eye represent a visual, refractive and corneal dilemma. A solidly designed protocol is needed to guide ophthalmologists in the diagnosis and treatment of patients with coexisting cataract and KC in the same eye. The protocol should address various issues under debate, such as whether the cataract or KC should be treated first. It should also address patient selection, intraocular lens (IOL) selection and optimum biometry formulae. A new term (i.e. KC-Plus) is needed to describe the existence of KC and cataract in the same eye.