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A Retrospective Review of Photorefractive Keratectomy to Enhance Earlier Radial Keratotomy

The radial keratotomy (RK) procedure consists of deep radial incisions into the cornea in a spoke-like rotation around the pupil. These cuts flatten the corneal curvature, reducing myopic refractive errors. However, the extent of the flattening and the duration of healing are somewhat unpredictable. For many patients, the flattening is progressive, leading to consecutive hyperopia with studies finding the continuing trend to be as much as 0.21 diopters (D) for up to 2 years and an additional 0.06 D every year subsequently. This trend toward progressive hyperopia and increased astigmatism and other patients with residual myopia has prompted a number of RK patients to seek corrective measures such as contact lenses, spectacles, and enhancement surgery years later. As these patients return in search of restored vision, they present unique challenges to today’s laser vision correction surgeries. The presence of the RK incisions can lead to complications, sometimes severe, from laser-assisted in situ keratomileusis (LASIK). Complications of photorefractive keratectomy (PRK) may also be increased such as post surgical corneal haze and loss of best-corrected visual acuity (BCVA).