Cataract Surgery on an Octogenarian Patient with a History of Hexagonal Keratotomy

Abstract

An 81-year-old female patient presents with poor vision and seeks options to improve her vision. The patient received a hexagonal keratotomy, an early refractive surgical technique used to improve hyperopia, more than 45 years prior. Due to the patient’s history, preemptive measures are taken to ensure corneal stability. Upon examination, dry eye disease, nuclear sclerosis, and cortical changes are present in both eyes. The patient has severe, irregular astigmatism. Preoperatively, aggressive treatment for dry eye disease was undertaken until stable biometry could be acquired. Femtosecond laser assisted cataract surgery was performed sequentially at a one-week interval. The patient had bilateral small-aperture lenses (Apthera/IC8 Bausch Health). Aggressive dry eye treatment continued postoperatively, and the patient's UCVA at distance was 20/30; at intermediate was 20/30; and at near was 20/30.