Refractive Results of Radial Keratotomy After 10 Years

BACKGROUND

We analyzed retrospectively the refractive and visual results of a cohort of patients who underwent radial keratotomy for myopia 10 years ago.

METHODS

Radial keratotomies using centripetal incisions were performed by the same surgeon in 1986 and 1987 to correct myopia of -0.75 to -10.00 diopters (D). Refractive and visual results were evaluated at 1 month and on average 10 years after surgery.

RESULTS

Thirty-nine patients (71 eyes) underwent radial keratotomy. Mean spherical equivalent refraction before surgery was -3.90 D and after surgery was -0.50 D at 1 month and +0.13 D at 10 years after surgery. At last examination, 41 eyes (43.7%) had a spherical equivalent refractive error within +/- 1.00 D of emmetropia (24 eyes [34%] +/- 0.50 D) and 32.4% of eyes were overcorrected by more than 1.00 D. Between 1 month and 10 years after surgery, a hyperopic shift greater than 1.00 D occurred in 34.1% of eves with a single procedure. Ten years after surgery, 59 eyes (83%) had uncorrected distance visual acuity of 20/40 or better (22 eyes [31%] with uncorrected visual acuity of 20/20 or better).

CONCLUSION

This retrospective evaluation confirms that radial keratotomy is an effective procedure to correct myopic error, but the hyperopic shift produces an unstable, less predictable refraction in one-third of eyes at 10 years.

[Acute open-angle glaucoma in a woman with AS hemoglobinopathy]

A 64-year-old black woman presented unilateral acute ocular hypertension. Gonioscopy showed a blood clot obstructing Schlemm's canal. Intraocular pressure returned to normal values after resorption of the blood clot. Hemoglobin electrophoresis found a sickle-cell trait, raising the hypothesis that the obstruction of outflow was probably due to the mechanism of sickling.