Laser in situ Keratomileusis for Overcorrection After Radial Keratotomy

To evaluate laser in situ keratomileusis (LASIK) for induced hyperopia after radial keratotomy.

Twenty eyes had LASEK for induced hyperopia after radial keratotomy. All eyes were treated using the Nidek excimer laser (EC-5000) and the Hansatome microkeratome with a 905-mm ring and 180-mm plate. Hyperopic correction was done using a 5.5 to 7.5-mm ablation zone.

Mean preoperative spherical equivalent refraction was +3.44 ± 1.25 D (range, +0.88 to +6.00 D). Postoperatively, all eyes achieved a reduction in hyperopia. At follow-up (range, ß to 24 mo), mean refraction was -0.66 ± 1.00 D (range, -2.25 to +1.50 D). At the last examination, 11 eyes (55%) were within ±0.50 D, 16 eyes (80%) were within ±1.00 D, and 19 eyes (95%) were within ±2.00 D of emmetropia. In terms of best spectacle-corrected visual acuity, 10 eyes (50%) saw 20/20 or better, 16 eyes (80%) saw 20/25 or better, and 18 eyes (90%) saw 20/40 or better. Regarding loss and gain of visual acuity lines, 11 eyes (55%) lost no lines, 2 eyes (10%) lost more than 2 lines, 1 eye (5%) lost 2 lines, 3 eyes (15%) lost 1 line, 1 eye (5%) gained 1 line, and 2 eyes (10%) gained 2 lines of visual acuity. Keratometric power increased from a preoperative mean of 37.32 ± 2.44 D (range, 33.80 to 43.13 D) to a postoperative mean of 39.64 ± 1.81 D (range, 37.42 to 43.74 D). Complications included 4 eyes with incisions that opened without any risk to the patient and in 2 eyes, epithelium ingrowth occurred in the interface.

LASBK for induced hyperopia after radial keratotomy is safe and effective, without vision-threatening complications. [J Refract Surg 2000;16(suppl):S253-S256].