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Changes in corneas shape after RK, PKP and keratoconus make it more challenging to pick the right IOL power in cataract surgery. The pinhole (small-aperture) IOL presents as an opportunity in these special situations.
The presence of irregular corneas cuts off the disturbing portion of the light that is aberrated by the irregularity. This lens can extend the depth of focus and provide excellent vision at distance, intermediate and near even in irregular corneas.