Retrospective comparison of simultaneous and non-simultaneous bilateral radial keratotomy

Many radial keratotomy surgeons advocate bilateral simultaneous surgery, in which there is an inherent, although rare, risk of bilateral sight-threatening complications such as microbial keratitis. This study was designed to evaluate the refractive outcomes of simultaneous and non-simultaneous radial keratotomy performed by a single surgeon.

We retrospectively compared the results of radial keratotomy performed simultaneously (both eyes operated on the same day, 20 patients) versus non-simultaneously (right and left eyes operated on different days, 71 patients) by a single surgeon. Both eyes had the same surgical procedure, including clear zone diameter and number of incisions.

The refractive results of bilateral simultaneous and non-simultaneous surgery were largely equivalent for all parameters analyzed except one. The variability of the difference in postoperative refractive error between right and left eyes was less for those patients undergoing simultaneous surgery (p = .0008).

Our data suggest that performing radial keratotomy as a bilateral simultaneous procedure increases the symmetry of the refractive effect. In view of recent reports of sight-threatening risks such as bilateral microbial keratitis following bilateral keratotomy, however, the potential risks and benefits of bilateral surgery should be carefully considered before operating on both eyes on the same day.