Progressive hyperopia with long-term follow-up of radial keratotomy

A number of studies have documented the reasonable efficacy and safety of radial keratotomy, but most were based upon results obtained one year or less after surgery. This study reviewed 109 consecutive radial keratotomy procedures performed on 79 patients between Nov 10, 1979, and Jan 31, 1981. In addition to a number of earlier postoperative visits, 81 eyes in 55 patients (74.3%) were examined between eight and 18 months postoperatively (a "one-year visit") and again between 31 and 57 months postoperatively (a "four-year visit"). Patients had uncorrected visual acuity determination, cycloplegic refractions with best-corrected visual acuity measurements, and keratometry. Of the 81 eyes, 17 (21.0%) became more myopic between one and four years postoperatively; five (6.2%) remained the same; and 59 (72.8%) became more hyperopic. With a significant change defined as 1.0 diopter or more, two eyes (2.5%) became significantly more myopic at four years; 54 eyes (66.7%) remained within 1.0 D of their one-year spherical equivalent; and 25 (30.9%) became significantly more hyperopic. Changes in keratometry generally paralleled refraction changes.