Surgical treatment of overcorrection following radial keratotomy: evaluation of clinical effectiveness

Secondary hyperopia following radial keratotomy (RK) may result from an initial overcorrection or from a continued effect of the procedure with time. We retrospectively evaluated the effect of surgical intervention for the management of overcorrection following RK in six patients who had undergone reopening of all RK incisions, followed by irrigation and closure of the incisions with 10-0 mersilene sutures. Three patients with prior 4-incision RK, with follow-up of 4 to 26 months, were steepened a mean of 1.63 diopters keratometrically; three patients with prior 8-incision RK, with follow-up of 3 to 12 months, were steepened a mean of 1.46 D keratometrically. Comparison of intraoperative with postoperative keratometry demonstrated a substantial loss of effect with time, which stabilized by 2 months in 4-incision RK patients and by 3 months in 8-incision RK patients. Nevertheless, placement of interrupted sutures across reopened radial incisions consistently induced central corneal steepening in these six patients.