Abstract
Background/objectives
This study shows the visual and refractive outcomes of cataract surgery in patients with previous radial keratotomy (RK).
Subjects/methods
This is a retrospective case series of 100 eyes (65 patients) with previous RK who had undergone routine cataract surgery with a monofocal intraocular lens implant (IOL) at Moorfields Eye Hospital, London, United Kingdom, between January 2004 and December 2018.
Results
Mean age at the time of surgery was 59.8 years; 39% eyes had ocular copathology. Best-corrected visual acuity (LogMAR; median, interquartile range) improved from 0.30 (0.22, 0.55) to 0.06 (−0.02, 0.21) in eyes without copathology, and from 0.56 (0.30, 1.00) to 0.20 (0.00, 0.20) in eyes with copathology. Haigis formula (19 eyes) resulted in a median prediction error of −0.31 D (−1.07, +0.05), versus −0.55 D (−1.23, +0.22) for Double-K SRK/T (55 eyes) and +0.93 D (0.20, 2.31) for SRK/T (18 eyes). At the final follow-up, 52.6% eyes were within 0.5 D and 68.4% within 1 D of the predicted spherical equivalent for Haigis, versus 32.7% and 52.7% for Double-K SRK/T, and 27.8% and 38.9% for SRK/T. The most frequent complication was RK incision dehiscence (8%).
Conclusions
Although the best-corrected visual acuity outcomes compare with the UK national benchmarks, significantly fewer eyes with previous RK achieved the level of unaided distance visual acuity to allow spectacle independence. Surgeons should be aware of the increased likelihood of wound dehiscence and plan surgery accordingly. Haigis formula tended to have a better predictability of the postoperative spherical equivalent and, since introduced, was the preferred choice for IOL calculation in this group of patients.
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Acknowledgements
We would like to thank Elyn Fernandez from the Audit Department at Moorfields Eye Hospital for the support in providing the case notes. Presented in part at the The Oxford Ophthalmological Congress, Oxford, UK, July 2019, the European Society of Cataract and Refractive Surgeons (ESCRS), Paris, France, September 2019, and United Kingdom and Ireland Society of Cataract and Refractive Surgeons (UKICRS), Hinckley, UK, October 2019.
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All authors contributed to the conception and design of the study and reviewed, critiqued and approved the final version of the paper. CS and DP undertook data collection, analysis and interpretation and drafted the paper. AI reviewed the paper and supervised the execution of the study.
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Soare, C., Patel, D.S. & Ionides, A. Cataract surgery outcomes in eyes with previous radial keratotomy. Eye 36, 1804–1809 (2022). https://doi.org/10.1038/s41433-021-01716-6
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DOI: https://doi.org/10.1038/s41433-021-01716-6
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