{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:40:08Z","timestamp":1756327208669,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,10,28]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p>A woman in her early 50s presented with diminution of vision, photophobia, pain and watering in right eye for 8 months. She had previously undergone radial keratotomy (RK) in the right eye, followed by bilateral angle-supported phakic intraocular lens (pIOL) implantation. On examination, 16 RK incisions were present in the right eye, with corneal decompensation, rigid angle-supported pIOL in situ, senile cataract and uncorrected distance visual acuity (UDVA) of counting fingers. Three major challenges were accurate biometry, incision management during phacoemulsification with rigid pIOL in situ and keratoplasty in the presence of RK incisions. Swept source optical coherence tomography-based optical biometer and Barrett Universal II formula were used for intraocular lens (IOL) power calculation. First-stage phacoemulsification was performed with pIOL in situ, followed by IOL implantation and pIOL explant via the same incision. Second-stage Descemet stripping automated endothelial keratoplasty (DSAEK) was performed after 1\u2009week; DSAEK prevented splicing of RK incisions. Postoperative UDVA was 20\/200, improving to 20\/60 with semiscleral contact lens.<\/jats:p>","DOI":"10.1136\/bcr-2024-261544","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T21:50:12Z","timestamp":1731534612000},"page":"e261544","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Phakic corneal decompensation with cataract after bioptics: management challenges"],"prefix":"10.1136","volume":"17","author":[{"given":"Vaibhav","family":"Namdev","sequence":"first","affiliation":[{"name":"Ophthalmology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manpreet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Ophthalmology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manvi","family":"Bansal","sequence":"additional","affiliation":[{"name":"Ophthalmology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6631-2099","authenticated-orcid":false,"given":"Jeewan S","family":"Titiyal","sequence":"additional","affiliation":[{"name":"Ophthalmology, Dr RP Centre, AIIMS, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,11,13]]},"reference":[{"key":"2025082713201864000_17.11.e261544.1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1994.01090220048022"},{"key":"2025082713201864000_17.11.e261544.2","doi-asserted-by":"crossref","DOI":"10.1186\/s40662-015-0022-6","article-title":"The evolution of corneal and refractive surgery with the femtosecond laser","volume":"2","author":"Aristeidou","year":"2015","journal-title":"Eye Vis"},{"key":"2025082713201864000_17.11.e261544.3","unstructured":"Titiyal JS , Kaur M , Nair S . Current Concepts in Refractive Surgery: Comprehensive Guide to Decision Making & Surgical Techniques. Jaypee Brothers Medical Publishers, 2021:151\u201360."},{"key":"2025082713201864000_17.11.e261544.4","doi-asserted-by":"crossref","first-page":"430","DOI":"10.3928\/1081597X-20090710-02","article-title":"An intraocular lens power calculation formula based on optical coherence tomography: a pilot study","volume":"26","author":"Tang","year":"2010","journal-title":"J Refract Surg"},{"key":"2025082713201864000_17.11.e261544.5","doi-asserted-by":"crossref","first-page":"131","DOI":"10.3928\/1081597X-20160106-01","article-title":"Femtosecond Laser-Assisted Cataract Surgery in Phakic Intraocular Lens With Cataract","volume":"32","author":"Kaur","year":"2016","journal-title":"J Refract Surg"},{"key":"2025082713201864000_17.11.e261544.6","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.4103\/ijo.IJO_423_18","article-title":"Phacoemulsification in phakic iris-claw lens with cataract","volume":"66","author":"Khokhar","year":"2018","journal-title":"Indian J Ophthalmol"},{"key":"2025082713201864000_17.11.e261544.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2012.04.025"},{"key":"2025082713201864000_17.11.e261544.8","first-page":"35","article-title":"Penetrating keratoplasty in keratoconic eyes with prior radial keratotomy","volume":"20","author":"Kubaloglu","year":"2010","journal-title":"Eur J Ophthalmol"},{"key":"2025082713201864000_17.11.e261544.9","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/S0161-6420(95)30929-3","article-title":"Penetrating keratoplasty after radial keratotomy. A report of six patients","volume":"102","author":"Parmley","year":"1995","journal-title":"Ophthalmology"},{"key":"2025082713201864000_17.11.e261544.10","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajoc.2019.100503","article-title":"Descemet membrane endothelial keratoplasty for endothelial decompensation after previous radial keratotomy","volume":"15","author":"Akella","year":"2019","journal-title":"Am J Ophthalmol Case Rep"},{"key":"2025082713201864000_17.11.e261544.11","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1097\/ICO.0b013e318295e705","article-title":"Descemet stripping automated endothelial keratoplasty for bullous keratopathy after anterior-posterior radial keratotomy","volume":"32","author":"Nakatani","year":"2013","journal-title":"Cornea"},{"key":"2025082713201864000_17.11.e261544.12","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.jcrs.2018.04.040","article-title":"Tomographic changes in eyes with hyperopic shift after triple Descemet membrane endothelial keratoplasty","volume":"44","author":"Cheung","year":"2018","journal-title":"J Cataract Refract Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:20:27Z","timestamp":1756326027000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":12,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,13]]},"published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1136\/bcr-2024-261544"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261544","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,11]]}}}