How do you approach cataract surgery in a patient who previously had radial keratotomy? Radial keratotomy (RK) is a type of eye surgery commonly performed in the 1980s and 1990s to correct nearsightedness. It involves making a series of incisions in the cornea to flatten it, which reduces its curvature and helps light focus properly on the retina. This patient required 50 incisions to flatten their cornea. Newer procedures like LASIK and PRK have made RK obsolete. But, fast forward 40 years, and many of these RK patients now need cataract surgery. Since the cornea has been altered with these radial cuts, it’s much harder for an ophthalmologist to accurately calculate the correct power of the lens replacement needed after cataract surgery. For some patients, a new type of replacement lens can help. It’s called the Light Adjustable Lens. It was approved by the FDA in 2017. If the calculations are off and the patient can’t see as well as they should after cataract surgery, this lens can be fine-tuned to improve vision. After the eye has healed from surgery, an ophthalmologist uses a device to apply ultraviolet light energy to the implanted lens, which is made of a photosensitive material that contains light-sensitive molecules, called macromers. The light produces changes in the curvature and refractive power of the lens. It’s a quick and painless procedure. Thanks, Dr. Pasricha!