Hyperopic shift after refractive keratotomy using the Casebeer System

To determine the degree of hyperopic shift following refractive keratotomy.

The Werblin Center, Princeton, West Virginia.

The results of 241 consecutive radial/astigmatic keratotomy procedures in 128 patients were studied. All procedures were performed using Casebeer nomograms. Refractive follow-up information was obtained for 78% of patients at 3 months (range 1 to 6 months), 1 year (range 6 to 21 months), and 3 years (range 30 to 44 months).

Overall, the amount of hyperopic change decreased significantly (P < .05) during the 3 year period, from + 0.34 diopters (D) per year to + 0.12 D per year. Eyes with more than 6.0 D of preoperative intended correction were more unstable (+ 0.49 D in the first year and + 0.44 D in the second and third years) than eyes with less than 5.0 D (+ 0.27 D and + 0.05, respectively).

Because the average magnitude of the hyperopic shift was + 0.6 D in the first 3 years after surgery, a slight undercorrection, -0.5 D to -0.7 D, should be the refractive endpoint for primary and enhanced refractive keratotomy surgery.