Enhancement techniques after incisional keratotomy

Area of Science:

• Ophthalmology
• Refractive Surgery

Background:

• Radial keratotomy (RK) can result in residual myopia.
• Enhancement procedures are sometimes necessary to correct undercorrection after RK.

Purpose of the Study:

• To evaluate the safety and efficacy of a four-step enhancement nomogram for reducing low residual myopia after incisional keratotomy.
• To assess the refractive outcomes and visual acuity following enhancement procedures.

Main Methods:

• Retrospective study of 86 eyes of 60 patients undergoing enhancement for residual myopia after RK.
• Utilized a four-step nomogram involving optical zone reduction (0.25 mm or 0.50 mm), adding incisions, and deepening procedures.
• Follow-up ranged from 6 to 42 months.

Main Results:

• All four enhancement techniques effectively reduced residual myopia.
• Optical zone reduction of 0.25 mm and 0.50 mm induced mean refractive changes of 0.662 D and 1.23 D, respectively.
• Post-enhancement visual acuity improved significantly, with no serious complications reported.

Conclusions:

• A four-step nomogram provides an effective and safe approach for managing residual myopia after RK.
• Optical zone reduction is a suitable initial strategy, with additional procedures useful for significant undercorrections.
• The nomogram allows incremental reduction of myopia without significant overcorrection.