Cataract Surgery After Radial Keratotomy: Lessons From My First Case

To present the surgical challenges, IOL power calculation considerations, and early outcomes of cataract surgery in a patient with previous radial keratotomy (RK).

A case report of a patient with visually significant cataract and a history of radial keratotomy. Preoperative assessment included corneal topography, optical biometry, and use of multiple post-RK IOL calculation formulas (Barrett True-K, Haigis-L, and ASCRS calculator). Surgical modifications were applied to minimize the risk of RK wound dehiscence. Postoperative refractive and visual outcomes were analyzed.

Cataract surgery was completed without intraoperative complications. Careful incision placement between RK scars and reduced phaco parameters were essential for surgical safety. Postoperatively, the patient achieved significant improvement in best-corrected visual acuity. Mild early refractive fluctuation was observed, consistent with altered corneal biomechanics in post-RK eyes.

Cataract surgery in post-keratotomy eyes remains challenging due to irregular corneal curvature, unstable keratometry, and IOL power unpredictability. Thorough preoperative planning, use of dedicated post-RK formulas, and surgical caution are crucial for optimal outcomes. Even in a first case, structured preparation can lead to safe and satisfactory visual rehabilitation.