Patients with prior radial keratotomy have specific challenges when it comes to cataract surgery such as performing accurate IOL power estimation and then again in the post op period where the RK incisions tend to swell thereby causing temporary central corneal flattening. During cataract surgery, radial keratotomy (RK) incisions can swell due to fluid ingress and mechanical stress, leading to temporary corneal instability and refractive changes. These incisions may gape or hydrate intra-operatively, altering corneal curvature and causing a hyperopic shift postoperatively. The degree of swelling depends on the number and depth of RK cuts. Corneal power typically takes several weeks to stabilize, often returning to baseline between 4 to 12 weeks after surgery. In this case the patient had the LAL Light Adjustable Lens treatment and lock-in prior to full stabilization of the corneal power. As such there was a residual refractive error that needed treatment with the piggyback IOL.
