{
  "abstract": "Purpose To report bilateral sequential phacoemulsification in a patient with high-myopia post-radial keratotomy (RK) corneas and bilateral chorioretinal atrophy, complicated by corneal wound dehiscence at an RK scar during intraocular lens (IOL) implantation in the second eye performed by a supervised resident, and to discuss the structural, refractive, and training-related implications of surgery in this challenging population. Case summary A 65-year-old man with bilateral 8-cut RK performed approximately 30 years prior for high myopia (− 16.00 D) presented with bilateral visually significant cataract. Axial length was 28–29 mm in both eyes; post-RK Scheimpflug tomography (Sirius, CSO) showed marked central flattening with simulated keratometry of approximately K1 29 D / K2 35 D bilaterally (mean central corneal power ≈ 31–33 D); preoperative BCVA was 0.05 (20/400) bilaterally due to pre-existing chorioretinal atrophy and posterior staphyloma. Right eye surgery by the senior surgeon (F.S.) was uneventful; a + 16.0 D IOL was implanted and postoperative BCVA reached 0.4–0.5. Left eye surgery was performed by a supervised resident under direct attending supervision. Phacoemulsification of a grade 2–3 nucleus was uneventful; however, during IOL unfolding and implantation, mechanical stress was transmitted along the tract of an old RK incision, precipitating full-thickness corneal wound dehiscence. The attending surgeon intervened immediately, repairing the dehiscence with three interrupted 10 − 0 nylon sutures. Final BCVA in the left eye was 0.3–0.4, limited primarily by pre-existing chorioretinal atrophy rather than by the intraoperative complication. Conclusion Post-RK corneas harbour latent structural vulnerabilities that may be unmasked by the mechanical forces of IOL implantation rather than phacoemulsification itself. These cases should be considered high-complexity and assigned exclusively to experienced surgeons. The bilateral design of this case provides a unique intraoperative comparison and highlights the necessity of pre-consent for suturing, realistic visual prognosis counselling, and strict case selection criteria in supervised surgical training programmes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ophthalmology, Faculty of Medicine, Recep Tayyip Erdogan University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Fatma Sumer"
    },
    {
      "affs": [
        0
      ],
      "name": "Ahmet Melih Oncirak"
    },
    {
      "affs": [
        0
      ],
      "name": "Bunyamin Can"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6dgk1zhca9beh.bib",
  "cited_by": 0,
  "doi": "10.1186/s12886-026-05153-5",
  "fulltext_url": "https://doi.org/10.1186/s12886-026-05153-5",
  "id": "6dgk1zhca9beh",
  "issns": [
    "1471-2415"
  ],
  "landing_url": "https://doi.org/10.1186/s12886-026-05153-5",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RE1-994"
    ],
    [
      "openalex",
      "2731|Intraocular Surgery and Lenses"
    ]
  ],
  "openalex": "W7170769189",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/6dgk1zhca9beh.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:45:42Z",
      "native_id": "3b71e2896b5b4e009fd0061f9a6f45d7",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s12886-026-05153-5"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2731|Intraocular Surgery and Lenses",
      "subfield": "general"
    }
  ],
  "title": "Corneal wound dehiscence at a radial keratotomy scar during iol implantation: a bilateral teaching case",
  "title_text": "Corneal wound dehiscence at a radial keratotomy scar during iol implantation: a bilateral teaching case",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:42Z",
  "url": "https://research.draconitic.com/paper/6dgk1zhca9beh",
  "venue": "BMC Ophthalmology",
  "versions": []
}