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.