Effect of corneal hydration and intraocular pressure on keratometric power after experimental radial keratotomy

Persistent diurnal fluctuations in vision are common after radial keratotomy (RK), associated with a myopic change in refraction and keratometric power as the day progresses. A possible relation between keratometric power and either intraocular pressure (IOP) or corneal hydration was investigated in a cadaver eye model. First, keratometric power was measured before and after RK while IOP was varied from less than 0.5 to 20 mmHg. A nonlinear relation was found; in particular, changes in IOP in the physiologic range had no effect on keratometric power after RK. In a second set of experiments, keratometric power was measured after RK as the dehydrated corneas were gradually hydrated with balanced salt solution. After RK, keratometric power decreased markedly as corneal hydration increased (0.33 diopters [D] per 10-microns increase in thickness). The keratometric power of control corneas was not affected by changes in IOP or hydration. The author concludes that diurnal fluctuations in refraction after RK are probably caused by diurnal fluctuations in corneal hydration rather than changes in IOP.