Decades ago millions of people had radial keratotomy (RK) as a corneal refractive surgery to address myopia. This tended to work pretty well and patients achieved close to emmetropia however we learned that over the years these RK incisions kept causing progressive corneal flattening and many of the patients shifted towards hyperopia. Now these patients who had RK done in their 20s and 30s are starting to develop cataracts. And cataract surgery in RK eyes is much different than in other eyes. For patients with 12, 16, 20, 24 or more radial cuts, the best choice for the incision tends to be a scleral tunnel. If the patient has 8 or fewer radial cuts then we can place the incision in the cornea between the existing RK incisions. This video shows my technique for making these incisions and the best way to avoid leakage from the RK cuts. I have personally done cataract surgery for thousands of patients with RK and I often do 3 or 4 of these patients per week. Watch carefully and learn all of my pearls.