Managing cataract surgery in an eye with prior corneal intra-stromal ring segments, such as Intacs, requires careful preoperative evaluation and thoughtful biometry. The altered corneal shape can create irregular measurements and produce unreliable readings if only standard keratometry is used. It is better to obtain measurements from several sources including Scheimpflug tomography, optical biometry, and manual keratometry to identify the most consistent corneal power. Corneal topography often provides the most dependable values because it captures localized steepening or flattening around the ring segments. During surgery the Intacs themselves rarely interfere with phacoemulsification, although incision placement should avoid areas of corneal thinning near the segments. And the bonus of this case is that our guest surgeon, who was on our CataractCoach Podcast yesterday, is operating on a fellow ophthalmologist and fellow cataract surgeon in this video!