Ten-year refractive and visual results of radial keratotomy.

Abstract

The authors evaluated the 10-year refractive and visual acuity results of a cohort of patients who underwent radial keratotomy (RK). A prospective cohort study was begun in 1980 of 198 consecutive myopic eyes of patients who were to undergo RK surgery. Patients were at least 18 years of age with myopia between 1.75 and 10 diopters. All patients signed consent forms. Refraction, uncorrected visual acuity (UVA), and best corrected visual acuity (BCVA) were the main outcomes evaluated at 10 years. Mean refraction at 10 years was -0.12 D, compared with -0.43 D at 5 years. Fifty-seven percent of eyes had UVA of at least 20/40 at 10 years, compared with 55% at 5 years. Improvement in UVA between 5 and 10 years occurred most frequently in eyes with most preoperative myopia and most surgery. Eighty-five percent of eyes had BCVA of at least 20/25 at 10 years, compared with 81% at 5 years. Women had significantly less myopia then men before surgery (P < 0.01), yet had similar UVA and worse BCVA. At 10 years, women had similar refraction but worse UVA and BCVA than men. Radial keratotomy was shown to be effective 10 years later. Some refractive and acuity changes occurred between 5 and 10 years follow-up, but these were mainly normal physiologic changes that occur with aging. Women had poorer vision than men before RK surgery and less beneficial results after surgery.