Laser in situ keratomileusis to correct hyperopic shift after radial keratotomy

PURPOSE: To assess the safety and efficacy of excimer laser in situ keratomileusis (LASIK) to correct hyperopic shift following radial keratotomy (RK). SETTING: Ophthalmic Health Center, Tel Aviv, Israel. METHODS: The study comprised 15 eyes of 12 patients who had uneventful RK and subsequently developed a hyperopic shift. Laser in situ keratomileusis was performed using the Chiron Automated Corneal Shaper and the Nidek EC-5000 excimer laser with 5.5 mm central and 7.5 mm peripheral ablation zones. The corneal flap was 160 microm in thickness and 8.5 mm in diameter. The refractive correction corresponded to the patients' refractive errors. RESULTS: The mean time after RK was 10.46 years +/- 2.21 (SD) and the mean follow-up after LASIK, 7.3 months (range 1 to 42 months). The mean spherical equivalent refraction was corrected from +3.08 +/- 1.02 diopters (D) to -0.16 +/- 0.73 D after LASIK. At the last examination, 12 eyes (80%) had a refractive error within +/-1.00 D of emmetropia and an uncorrected visual acuity of 20/40 or better. No wound dehiscence, epithelial ingrowth, or other significant complication developed in any eye. CONCLUSIONS: Early postoperative results of the correction by LASIK of a hyperopic shift after RK are encouraging, but long-term studies of a larger population group are required to evaluate the method's clinical value.