Radial keratotomy (RK) is an out-dated kerato-refractive surgery where radial incisions were made in the cornea in order to cause central flattening and thereby address myopia. When the excimer laser came to market in the 1990s, radial keratotomy fell by the wayside and it has not been performed for decades. But the patients who had RK 30 years ago are now developing lens opacities and are requiring cataract surgery.
When evaluating the RK incisions, there are a few factors to consider: How many incisions are there? How deep are the incisions? How close do the incisions extend to the limbus? How small is the central optical zone? Are there arcuate keratotomy(AK) incisions? Are there areas of epithelial ingrowth into the incisions? How stable has the keratometry been over the past few months and years?
And for cataract surgery, what portion of the patient’s visual decline is due to the cataract versus the cornea? Is there sufficient room to safely place the phaco incision between the RK cuts or is a scleral tunnel incision required?
Click below to learn how to evaluate radial keratotomy patients prior to cataract surgery: