While radial keratotomy (RK) is rarely used as a refractive surgery today, a few decades ago it was very popular. Those patients who had RK done in the 1980s and even into the 1990s and presenting to our clinics with significant cataracts 30 or 40 years after the RK was performed. The RK was used to treat myopia with the radial cuts being at least 90% depth and causing central corneal flattening. More RK cuts typically meant a higher degree of myopia was treated. The RK worked well for these patients for many years, but eventually the central corneal flattening effect becomes more pronounced and these once myopic patients then drift into hyperopia. Most of these patients present to our clinics for cataract surgery with hyperopic refractions.
Cataract surgery has the ability to address this hyperopic refractive error and even any astigmatism by virtue of the IOL. Note that these patients do best with a monofocal IOL and advise to avoid using a multifocal IOL in these eyes because the irregular corneal surface may already have a multi-focal effect. The IOL power will need to be properly calculated and remember that you cannot simply use the regular calculations lest you will end up with a hyperopic post-op surprise.
this video gives you my best secrets for success in radial keratotomy patients: