Factors affecting outcome and predictability of radial keratotomy in the PERK Study

The Prospective Evaluation of Radial Keratotomy (PERK) study used a standardized surgical technique that included a central clear zone with a diameter of 4.0, 3.5, or 3.0 mm. Multiple regression analysis of the outcome in one eye from each of 411 patients disclosed that the diameter of the central clear zone, patient age, and depth of the incision scar were the major factors affecting the change in refraction one year after surgery. Preoperative factors examined that did not have a significant influence on the outcome were sex, average central keratometric power, corneal thickness, corneal diameter, intraocular pressure, and ocular rigidity. The predictability of radial keratotomy, ie, the precision with which the outcome can be estimated, was measured by the 90% confidence interval for the change in refraction based on the regression equation. The width of this interval within each clear zone group was as follows: 4.0 mm, 2.49 diopters; 3.5 mm, 3.38 D; 3.0 mm, 4.12 D. For all 411 eyes, the 90% confidence interval was approximately 3.50 D wide. Thus, the surgeon could be 90% certain that an individual patient's refraction would be within 1.75 D of the predicted value one year after surgery.