Wound instability and management after cataract surgery in a patient with prior laser in situ keratomileusis

We report a case of cataract wound instability and subsequent management after cataract surgery in a patient who had had hyperopic laser in situ keratomileusis (LASIK). Standard cataract surgery was performed through a nasal limbal incision. One day postoperatively, the uncorrected visual acuity (UCVA) was 20/20 and the wound was stable. Subsequent examinations revealed overlying corneal edema, cataract wound slippage with corresponding with-the-rule astigmatism, and decreased vision. Separating and resuturing the cataract wound resulted in significant and stable improvement in the UCVA to 20/40. At 18 months, the best corrected visual acuity was 20/20 with a retraction of -3.50 + 0.25 x 155 and keratometry of 44.75/45.00 @ 155. Understanding wound stability and its management in cataract surgery in patients with prior LASIK refractive surgery will become increasingly important as more of these patients present.