Rare case of Ruiz procedure managed with successful phacoemulsification

Ruiz first described a procedure in 1981 as trapezoidal cuts; four cuts inside two radial incisions, which he labeled as the Ruiz procedure. This procedure aims to correct a large amount of astigmatism and is also known as trapezoidal keratotomy. Here the authors describe a rare and interesting case of a 56-year-old male patient who presented with chief complaints of diminution of vision in both eyes (OU) for the past 6 months. The best corrected visual acuity was 20/40 in OU. Slit-lamp examination revealed a central clear zone and radial incisions with transverse step ladder pattern incisions at 3 and 9 o'clock paralimbal cornea, suggestive of the old Ruiz procedure in OU. The lens was nuclear sclerosis grade IV in OU. After routine investigations, the patient underwent successful phacoemulsification in OU with the best-corrected visual acuity of 20/20. Ruiz procedure is rare in clinical outpatient departments (OPDs), and planned interventions can have a successful outcome in these cases.