T-hex keratotomy surgically corrects manifest hyperopia. The typical patient presenting for this surgery is a presbyope who develops symptoms from latent hyperopia. These patients are older than typical radial keratotomy patients and are thus likely to develop senile cataracts sooner. The exact surgical approach to cataract surgery in such patients is unknown. We report a patient who had successful cataract extraction by phacoemulsification with implantation of a posterior chamber lens after a previous routine T-hex keratotomy. The preoperative workup and the surgical technique did not require modification.