Excimer laser keratectomy after radial keratotomy

Radial keratotomy to treat myopia has been characterized by a lack of predictability. Until recently, patients with undercorrected myopia who were unsatisfied with their visual outcome could only be offered secondary augmentation procedures, which were equally unpredictable. We performed excimer laser keratectomy in six eyes of five patients whose myopia was undercorrected after radial keratotomy. The average residual spherical equivalent refractive error after radial keratotomy was -2.40 diopters, and this was reduced to -0.48 diopters after laser treatment. Final uncorrected visual acuity ranged from 20/80 to 20/20, and visual acuity was corrected to within one line of the preoperative best-corrected value in all patients. Epithelialization of all eyes occurred within four to six days. There were no incidences of corneal neovascularization, including no vascularization of the radial keratotomy incisions. Our findings suggest excimer phototherapeutic keratectomy offers a safe and more controlled method of augmenting undercorrected myopia after radial keratotomy.