Light-adjustable lens in eyes with a history of radial keratotomy

To evaluate visual and refractive outcomes in eyes with a history of radial keratotomy (RK) implanted with the second-generation light-adjustable lens (LAL).

Private practice, multiple locations.

Retrospective, consecutive case series.

Eyes with a history of RK that underwent cataract surgery with implantation of the LAL and were targeted for emmetropia before lock-in were included. Data on the type and number of prior refractive surgeries were collected, in addition to the timing and number of postoperative adjustments. The primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity, and the percentage (%) of eyes within ±1.00 diopter (D), ±0.50 D, and ±0.25 D and of their refractive target.

94 eyes from 77 patients were included. 28% (n = 26) were a history of 4-cut RK, 12% (n = 11) were 6-cut RK, 55% (n = 52) were 8-cut RK, and 5% (n = 5) were 16-cut RK. Overall, 82% (n = 77) of all eyes achieved 20/25 UDVA or better, 74% (n = 70) of all eyes achieved UDVA of 20/20 or better, and 94% (n = 88) were correctable to 20/20 or better postoperatively. For refractive outcomes, 98% (n = 92) of eyes were within ±1.00 D of target, 88% (n = 83) were within ±0.50 D, and 69% (n = 65) were within ±0.25 D of preoperative refractive target.

Patients with a history of RK achieved favorable visual and refractive outcomes with the LAL. Postoperative light adjustments should be delayed to allow for refractive stabilization. The LAL is a promising option for post-RK patients who are motivated to obtain favorable uncorrected acuity after cataract surgery.