Bilateral Light-Adjustable Lens Implantation in a Patient With 50-Cut Radial Keratotomy

Abstract

Purpose: The purpose of this study was to report a case of light-adjustable lens (LAL; RxSight, Aliso Viejo, CA) implantation in a patient with bilateral 50-cut radial keratotomy (RK) and discuss related preoperative, intraoperative, and postoperative considerations. Methods: A 78-year-old patient with a history of bilateral 50-cut RK underwent phacoemulsification with implantation of LALs in both eyes 1 month apart. Although LAL technology was not approved specifically for addressing limitations in intraocular lens calculation post-RK due to corneal topography irregularity, the patient opted for this lens due to its ability to make postoperative adjustments to its refractive power. At postoperative month 1 following the second-eye surgery, YAG capsulotomy was performed in both eyes. At postoperative month 2 following the second-eye surgery, the patient began LAL adjustments spaced 1 to 2 weeks apart for a total of 2 LAL adjustments and 2 lock-in sessions. Results: Our patient achieved a final refraction of −0.25 +0.25 × 110 with an UDVA of 20/20-2 in the right eye and −0.25 + 0.50 × 135 with an UDVA 20/25-1 in the left eye. Conclusions: The LAL may be a promising option for patients undergoing cataract surgery after RK, although further studies are needed to understand long-term changes in eyes with RK and the inability of LAL to address all aspects of corneal aberration.