Phacoemulsification following previous radial keratotomy

We followed a 45-years-old man who underwent clear cornea phacoemuisification cataract extraction 3 years after radial keratotomy during an 18-month period. We report early and late refractive analysis and corneal topography during the follow-up period. The patient experienced an hyperopic shift which was different from the aim of 5 diopters due to an early corneal flattening of 3 diopters and an underestimation of the IOL power of 2 diopters using SRK-II calculation formula, corneal flattening regressed after 3 weeks. We recommend that these patients should be informed of an eventual early hyperopic shift and late refractive error, that Binkhorst-II or Hoffer-Q intraocular lens calculation formulas be used and keratometry measurements be obtained from computerized videokeratography.