Lensectomy after radial keratotomy: 1-year follow-up

Accuracy of Astigmatism Correction with Toric Intraocular Lens Implantation in Eyes with Prior Radial Keratotomy

PURPOSE

To evaluate refractive outcomes of toric intraocular lens (IOL) implantation in eyes with previous radial keratotomy (RK).

SETTING

Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA.

DESIGN

Retrospective case series.

METHODS

Consecutive cases with previous RK and had undergone cataract surgery with Toric IOL implantation and met these criteria were retrospectively reviewed: (1) regular bowtie corneal astigmatism within the central 3.0-mm zone, (2) difference in corneal regular astigmatism magnitude between the IOL Master and Lenstar of ≤ 0.75 D, and (3) difference in the regular astigmatism meridians from the 2 biometers of ≤ 15 degrees, and (3) available postoperative manifest refraction at ≥ 8 weeks with corrected distance visual acuity of 20/30 or better. Vector analysis was used to assess the preoperative corneal and postoperative refractive astigmatism.

RESULTS

In 40 eyes of 31 patients with previous RK, preoperatively the mean magnitude of corneal regular astigmatism was 2.10 ± 0.98 diopters (D), 1 (3%) and 2 (10%) eyes had anterior corneal regular astigmatism ≤0.5 D and ≤1.0 D respectively, and the centroid value was 1.14 D @ 179° ± 2.05D. Postoperatively, the mean magnitude of refractive regular astigmatism was 0.46 ± 0.44D (D), 29 (73%) and 35 (88%) of eyes had refractive regular astigmatism ≤0.5 D and ≤1.0 D respectively, (P<0.05), and the centroid value was 0.12 D @ 173° ± 0.63 D (P<0.05).

CONCLUSIONS

Toric IOLs can be used successfully to treat corneal regular astigmatism in eyes with previous RK.

Light Adjustable Intraocular Lens for Cataract Surgery After Radial Keratotomy

PURPOSE

To describe a case of light adjustable lens implantation after radial keratotomy.

METHODS

A patient with a 30-year history of radial keratotomy subsequently underwent phacoemulsification with implantation of intraocular light adjustable lenses. Serial refractions were performed at varying hours of the day postoperatively and were repeated for 3 months. The light adjustable lenses were adjusted twice, and the refractive power of the implant was eventually locked.

RESULTS

The patient was able to achieve uncorrected distance visual acuity of 20/25 in both eyes, improving from 20/125 in the right eye and 20/80 in the left eye, with no surgical complications.

CONCLUSIONS

The authors report the first case of light adjustable lens implantation after radial keratotomy, which has yielded promising results for mitigating intraocular lens miscalculations after radial keratotomy. [J Refract Surg. 2020;36(12):852-854.].