Cataract surgery after holmium:YAG laser thermal keratoplasty

A 64-year old man had noncontact holmium:YAG (Ho:YAG) laser thermal keratoplasty (LTK) performed in the left eye on March 10, 1998, and in the right eye on January 11, 1999. The patient achieved 1.3 diopters (D) and 1.4 D of corneal steepening in the right and left eye, respectively, which was the desired amount as his refractive error before Ho:YAG LTK was low. At the 3-month postoperative examination of the left eye, cortical cataracts were observed in both eyes. Approximately 1 year later, bilateral cataract extraction was recommended because of patient-reported decreased vision at distance and near and difficulty with vision in the presence of glare. Cataract surgery and intraocular lens (IOL) implantation was performed in both eyes in August 1999 using the keratotomy readings taken after noncontact Ho:YAG LTK to calculate IOL power. Although slight flattening of the cornea occurred after cataract extraction, the refractive outcomes achieved by noncontact Ho:YAG LTK were generally preserved.