Eye with RK incisions and stabilizing suture

RK & Cataracts: Can You Reduce the Risk of Dehiscence?

Jordan Keane in Health & Wellness August 2025 • 4 min read.

"Navigating cataract surgery after radial keratotomy (RK) is tricky. Discover how a simple suture technique can significantly lower dehiscence risks and improve patient outcomes."

Radial keratotomy (RK), once a popular vision correction surgery, has given way to newer techniques like LASIK and PRK. However, many who underwent RK in the 90s are now facing age-related cataracts, creating unique challenges for cataract surgeons.

One of the primary concerns during cataract surgery on post-RK patients is the risk of dehiscence—the separation of RK incisions. This complication can lead to instability and affect the visual outcome. But, there's good news: a study published in the International Journal of Ophthalmology highlights a technique to minimize this risk.

This article delves into the findings of this research, focusing on a precautionary suture method that stabilizes the cornea during cataract surgery. Whether you're a patient considering cataract surgery after RK or simply interested in the latest advancements in ophthalmology, this information will help you navigate this intersection of past and present vision correction techniques.

Understanding the Challenge: Cataract Surgery After RK

Eye with RK incisions and stabilizing suture

Cataract surgery on patients with a history of radial keratotomy (RK) presents unique challenges due to the altered biomechanics of the cornea. RK involves making radial incisions in the cornea to correct myopia (nearsightedness) and astigmatism. These incisions, while effective in reshaping the cornea, can weaken it and make it more prone to complications during subsequent surgeries.

One of the most significant risks is dehiscence, where the RK incisions reopen during cataract surgery. This can occur due to the pressure and manipulation involved in the procedure, potentially leading to corneal instability, increased astigmatism, and compromised visual outcomes. Managing this risk is crucial for ensuring the success of cataract surgery in post-RK patients.

Corneal Weakness: RK incisions weaken the cornea, making it more susceptible to separation during surgery.
Increased Astigmatism: Dehiscence can lead to irregular corneal shape and increased astigmatism.
Unpredictable Outcomes: The altered corneal structure makes it challenging to predict the refractive outcome of cataract surgery.
Surgical Precision: Special techniques and careful planning are required to minimize the risk of complications.

To address these challenges, ophthalmologists have explored various strategies to enhance corneal stability during cataract surgery in post-RK patients. One promising approach involves the strategic placement of sutures to reinforce the RK incisions, preventing dehiscence and promoting better visual outcomes. Let's examine a study that investigates the effectiveness of this technique.

The Stabilizing Suture: A Game-Changer?

The study's findings strongly suggest that a precautionary stabilizing suture can significantly reduce the risk of dehiscence during cataract surgery in post-RK patients. By placing a suture across the RK incision adjacent to the main surgical tunnel, surgeons can reinforce the weakened cornea and prevent the separation of incisions.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What is radial keratotomy (RK), and why is it relevant to cataract surgery?

Radial keratotomy (RK) is a refractive surgery procedure used to correct nearsightedness and astigmatism by making radial incisions in the cornea. This reshapes the cornea to improve vision. While it was popular in the past, newer techniques like LASIK and PRK have become more common. However, individuals who underwent RK years ago may now develop cataracts, requiring cataract surgery. The prior RK can complicate cataract surgery due to weakened corneal structure.

What is dehiscence, and why is it a concern in cataract surgery after radial keratotomy (RK)?

Dehiscence refers to the separation or reopening of the original radial incisions made during the radial keratotomy (RK) procedure. This is a significant concern during subsequent cataract surgery in post-RK patients because the RK incisions weaken the cornea, making it more prone to separation. Dehiscence can lead to corneal instability, increased astigmatism, and unpredictable visual outcomes after cataract surgery, potentially compromising the success of the procedure.

What is a stabilizing suture, and how is it used in cataract surgery for post-RK patients?

A stabilizing suture is a surgical technique used during cataract surgery on patients who have previously undergone radial keratotomy (RK). It involves placing a suture across or near the RK incisions to reinforce the weakened cornea and prevent dehiscence. This precautionary measure helps to maintain corneal stability during the cataract surgery, reducing the risk of complications and improving visual outcomes. The suture acts as a support, minimizing the chance of the RK incisions reopening due to surgical manipulation.

Why is cataract surgery more challenging after someone has had radial keratotomy (RK)?

Cataract surgery after radial keratotomy (RK) presents unique challenges primarily due to the altered biomechanics and weakened state of the cornea. The original RK incisions can make the cornea more susceptible to complications like dehiscence during cataract surgery. This risk requires careful surgical planning, specialized techniques, and potentially the use of stabilizing sutures to reinforce the cornea and ensure a successful outcome. The altered corneal structure can also make it more challenging to predict the refractive outcome of the cataract surgery.

Why is the precautionary stabilizing suture technique important during cataract surgery after RK?

The precautionary stabilizing suture technique is important because it helps to minimize the risk of dehiscence during cataract surgery in patients with a history of radial keratotomy (RK). By reinforcing the weakened cornea with a suture, surgeons can prevent the separation of RK incisions, which can lead to corneal instability, increased astigmatism and compromised visual outcomes. Using this technique contributes to a more predictable and successful cataract surgery.