[Cataract surgery after refractive surgery. Part I: practical surgical consequences]

Prior refractive surgery has little incidence on the phako-exeresis technique. Most of the precautions taken are based more on theoretical considerations rather than extensive clinical experience. Excepting cases of high myopy corrected with IOL where early opacification may have occurred, mo st of the population undergoing refractive surgery has not yet reached the age of cataracts. In case of prior corneal surgery (radial keratotomy, PKR, Lasik or intracorneal ring segments) the incision tunnel must remain behind or away from the anatomically modified sectors. In case of prior refractory surgery, explantation must always precede the procedure. A large diameter (6mm or more) lens is always chosen in order to ava avoid optical consequences of modifications induced by the aspheric cornea.