Effects and risks of 3.2-mm transparent corneal incision phacoemulsification for cataract after radial keratotomy

Objective This study was performed to analyze the visual outcomes and complications of phacoemulsification using a 3.2-mm transparent corneal incision in eyes with cataract after radial keratotomy (RK). Methods We retrospectively reviewed cases of lens phacoemulsification and intraocular lens implantation after RK. The main measurement results were postoperative best-corrected visual acuity (BCVA), endothelial cell density, and complications. Results Overall, 19 eyes of 12 patients with 8 (n = 6), 12 (n = 7), and 16 (n = 6) RK cuts were included in the study. Intraoperative wound dehiscence occurred in two eyes with 16 RK cuts. Successful phacoemulsification with intraocular lens implantation was performed in all eyes. The mean BCVA at the last follow-up (0.19 +/- 0.13 LogMAR) was significantly better than the preoperative BCVA (0.72 +/- 0.54 LogMAR). However, there was a significant reduction in the corneal endothelial cell density after surgery (2384.0 +/- 833.4/mm(2) vs. 1716.95 +/- 906.79/mm(2)). Conclusions Surgeons should be aware of the risk of wound dehiscence in patients who undergo phacoemulsification after RK. A small transparent corneal incision or scleral tunnel incision is recommended.