Radial keratotomy was a popular refractive procedure in the late 20th century, offering millions of patients a large degree of spectacle freedom.Decades later, these patients develop cataracts and progressive hyperopia as the cornea continues to flatten. In addition, these deep corneal stromal incisions can cause diurnal fluctuations as the corneal architecture and power can waver daily. When these patients present to our clinic for cataract surgery, we can address the lens opacity, the refractive error and the diurnal fluctuations at the same time.Patients report a predictable corneal
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