A Case of Cataract Surgery after Radial Keratotomy

Eun Jung Lee; Jong Chul Han; Chang Won Kee

doi:10.3341/jkos.2014.55.7.1089

Journal List > J Korean Ophthalmol Soc > v.55(7) > 1009734

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Lee, Han, and Kee: A Case of Cataract Surgery after Radial Keratotomy

Case Report

J Korean Ophthalmol Soc 2014;55(7):1089-1092.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.7.1089

A Case of Cataract Surgery after Radial Keratotomy

Eun Jung Lee, MD, Jong Chul Han, MD, Chang Won Kee, MD, PhD

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Address reprint requests to Chang Won Kee, MD, PhD, Department of Ophthalmology, Samsung Medical Center, #81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea, Tel: 82-2-3410-3569, Fax: 82-2-3410-0029 E-mail: ckee@skku.edu

Received 7 December 2013 Revised 11 March 2014 Accepted 9 June 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a patient who underwent successful cataract surgery without wound dehiscence in the eye that had undergone previous radial keratotomy by performing a clear corneal incision between previous incisions.

Case summary

A 59-year-old female visited our medical center for decreased vision. The patient underwent radial keratotomy for correction of myopia in both eyes 11 years prior. On slit-lamp examination, cataract and eight radial keratotomy incisions were found. Phacoemulsification and posterior capsule intraocular lens implantation were performed for both eyes at a one-week interval. For the right eye, a clear corneal incision was made over the previous incision scar and wound dehiscence was successfully managed by prompt corneal suturing. For the left eye, a clear corneal incision was made between the previous incision scars, and wound dehiscence did not occur.

Conclusions

As radial keratotomy patients age, cataract surgery should be considered. A successful surgery was possible without wound dehiscence in an eye that had undergone previous radial keratotomy in which a clear corneal incision was made between previous incision scars.

Keywords: Cataract surgery, Radial keratotomy, Wound dehiscence

References

1. Fyodorov SN, Durnev VV. Operation of dosaged dissection of corneal circular ligament in cases of myopia of mild degree. Ann Ophthalmol. 1979; 11:1885–90.

2. Budak K, Friedman NJ, Koch DD. Dehiscence of a radial keratotomy incision during clear corneal cataract surgery. J Cataract Refract Surg. 1998; 24:278–80.

3. Behl S, Kothari K. Rupture of a radial keratotomy incision after 11 years during clear corneal phacoemulsification. J Cataract Refract Surg. 2001; 27:1132–4.

4. Girard LJ, Rodriguez J, Nino N, Wesson M. Delayed wound healing after radial keratotomy. Am J Ophthalmol. 1985; 99:485–6.

5. Chu R, Hardten D, Thomas D. Radial keratotomy. In : Duane TD, Tasman W, Jaeger EA, editors. Duane's clinical ophthalmology. Philadelphia: Lippincott Williams & Wilkins;2006.

6. Binder PS, Nayak SK, Deg JK, et al. An ultrastructural and histochemical study of long-term wound healing after radial keratotomy. Am J Ophthalmol. 1987; 103:432–40.

7. Maxwell WA. Myopic keratomileusis: initial results and myopic keratomileusis combined with other procedures. J Cataract Surg. 1987; 13:518–24.

8. Beatty RF, Robin JB, Schanzlin DJ. Penetrating keratoplasty after radial keratotomy. J Refract Surg. 1986; 2:207–14.

9. McNeill JI. Corneal incision dehiscence during penetrating keratoplasty nine years after radial keratotomy. J Cataract Refract Surg. 1993; 19:542–3.

10. Freeman M, Kumar V, Ramanathan US, O'Neill E. Dehiscence of radial keratotomy incision during phacoemulsification. Eye (Lond). 2004; 18:101–3.

11. Chen L, Mannis MJ, Salz JJ, et al. Analysis of intraocular lens power calculation in post-radial keratotomy eyes. J Cataract Refract Surg. 2003; 29:65–70.

12. Han ES, Lee JH. Intraocular lens power calculation in high myopic eyes with previous radial keratotomy. J Korean Ophthalmol Soc. 2006; 47:1244–50.

13. Holladay JT. Cataract surgery in patients with previous keratorefractive surgery (RK, PRK and LASIK). Ophthalmic Pract. 1997; 15:238–44.

14. Seitz B, Langenbucher A. Intraocular lens power calculation in eyes after corneal refractive surgery. J Refract Surg. 2000; 16:349–61.

15. Holladay JT. Consultations in refractive surgery. J Refract Corneal Surg. 1989; 203–5.

16. Hoffer KJ. Intraocular lens power calculation for eyes after refractive keratotomy. J Refract Surg. 1995; 11:490–3.

17. Lyle WA, Jin GJ. Intraocular lens power prediction in patients who undergo cataract surgery following previous radial keratotomy. Arch Ophthalmol. 1997; 115:457–61.

18. Celikkol L, Pavlopoulos G, Weinstein B, et al. Calculation of intraocular lens power after radial keratotomy with computerized videokeratography. Am J Ophthalmol. 1995; 120:739–50.

19. Srivannaboon S, Reinstein DZ, Sutton HF, Holland SP. Accuracy of Orbscan total optical power maps in detecting refractive change after myopic laser in situ keratomileusis. J Cataract Refract Surg. 1999; 25:1596–9.

20. Holladay JT, Hill WE, Steinmueller A. Corneal power measurements using scheimpflug imaging in eyes with prior corneal refractive surgery. J Refract Surg. 2009; 25:862–8.

21. Potvin R, Hill W. New algorithm for post-radial keratotomy intraocular lens power calculations based on rotating Scheimpflug camera data. J Cataract Refract Surg. 2013; 39:358–65.

22. Damiano RE, Forstot SL, Frank CJ, Kasen WB. Purse-string sutures for hyperopia following radial keratotomy. J Refract Surg. 1998; 14:408–13.

23. Nosé W, Endriss D, Forseto AS. Corneal suture for the correction of hyperopia following radial keratotomy. J Refract Surg. 2007; 23:523–7.

Figure 1.

For the surgery of the right eye, a clear corneal incision was made with temporal approach over previous radial keratotomy incision site (A). Wound dehiscence developed during the surgery and 2 corneal sutures were performed with 10-0 nylon. For the surgery of the left eye, clear corneal incision was made between 45 and 90 degrees of angle to avoid previous radial keratotomy incision and resulted in successful surgery without wound dehiscence (B).

Figure 2.

Anterior segment photograph. On the 8th postoperative day from the right eye surgery, corneal sutures of the right eye and radial keratotomy incision scars of both eyes are stable without dehiscence.

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