Predicting the results of radial keratotomy

Radial keratotomy on 251 patient eyes was performed. Patients traversing the one-year gate after surgery have demonstrated a refractive change best predicted by the optical zone size, the number of incisions, the corneal dissymmetry, and the age of the patient. One year after surgery, a 16-incision radial keratotomy with 3.0-mm optical zone produced 4.66 diopters of refractive change if the limbus was traversed (N = 13), and 5.18 diopters of refractive change if all incisions remained in clear cornea (N = 39). An eight-incision, 3.0-mm optical zone radial keratotomy produced 5.21 diopters of refractive change at one year (N = 37). A 3.5-mm optical zone, eight-incision radial keratotomy produced 3.66 diopters of change at one year (N = 6). A 4.0-mm optical zone produced 2.67 diopters of change with 16 incisions (N = 8), and 3.45 diopters of change with eight incisions at one year (N = 9). Although older patients appear to have significantly greater refractive change with radial keratotomy at the three-month gate, this difference is not yet confirmed at one year after surgery. The shape of the cornea before surgery contributes to the predictability of the refractive results when the horizontal and vertical keratometer measurements are analyzed. Corneal dissymmetry produces greater refractive results with steeper horizontal K when against-the-rule astigmatism is present before surgery.