Pearls for successful cataract surgery with endothelial keratoplasty

Purpose of review This article reviews the current methods of improving outcomes when cataract surgery and endothelial keratoplasty are performed together. Recent findings The refractive shift after endothelial keratoplasty is well known and can negatively affect achieving emmetropia after concomitant cataract surgery. Recent articles have described ways of achieving better refractive outcomes, including the use of nomograms and mathematical models. Specific operative techniques are recommended to minimize graft failure and dislocation when cataract surgery is also performed. There have been few recent reports on the use of 'premium' intraocular lenses in the setting of endothelial keratoplasty with variable results. Summary Surgeons are achieving better refractive outcomes without compromising graft clarity in combined endothelial keratoplasty and cataract surgery.