Bilateral Light-Adjustable Lens Implantation in a Patient With 50-Cut Radial Keratotomy

Area of Science:

• Ophthalmology
• Refractive Surgery
• Cataract Surgery

Background:

• Radial keratotomy (RK) can create irregular corneal topography, complicating intraocular lens (IOL) calculations for cataract surgery.
• The Light Adjustable Lens (LAL) offers adjustable refractive power post-implantation, a unique feature for managing complex refractive cases.

Purpose of the Study:

• To report the outcomes of Light Adjustable Lens (LAL) implantation in a patient with a history of bilateral radial keratotomy (RK).
• To discuss the preoperative, intraoperative, and postoperative considerations specific to using LALs in eyes with prior RK.

Main Methods:

• A 78-year-old patient with bilateral 50-cut RK underwent phacoemulsification and LAL implantation in both eyes.
• Postoperative adjustments to the LAL's refractive power were made over several weeks.
• YAG capsulotomy was performed in both eyes one month after the second surgery.

Main Results:

• The patient achieved a final uncorrected distance visual acuity (UDVA) of 20/20-2 in the right eye and 20/25-1 in the left eye.
• Final refraction was -0.25 +0.25 × 110 in the right eye and -0.25 +0.50 × 135 in the left eye.

Conclusions:

• The LAL may be a viable option for cataract surgery patients with a history of RK, offering refractive adjustability.
• Further research is necessary to fully understand the long-term behavior of LALs in RK eyes and their limitations in correcting corneal aberrations.