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RADIAL KERATOTOMY FOR MYOPIA: LONG-TERM OUTCOMES.

Radial keratotomy is a controversial procedure in which partial-thickness incisions are made in the cornea in an attempt to correct myopia. To address some of the claims made about the procedure, the authors of the multicenter Prospective Evaluation of Radial Keratotomy (PERK) Study report four-year outcomes in 435 adults who underwent the procedure at the hands of ten surgeons.

Of the 323 patients who had surgery on both eyes, 64 percent no longer needed corrective lenses. The large percentage who still required vision correction reflects the difficulty of predicting the amount of refractive change that often occurs after the procedure. Twenty-eight percent of eyes were undercorrected, and 17 percent were overcorrected. Initially good outcomes were not necessarily stable: among the 341 eyes that had undergone a single operation, 82 eyes (24 percent) had 1 diopter or more of continued surgical effect, and 13 (4 percent) had 1 diopter or more of loss of surgical effect. Serious complications were rare.

These data indicate that radial keratotomy, in experienced hands, is reasonably safe and allows many patients to put away their glasses (at least for four years). Nevertheless, as an accompanying editorial notes, the operation is not perfect and should not be recommended to all myopic patients.

— THL

Published in Journal Watch General Medicine March 2, 1990

Citation(s):

Binder PS. Radial keratotomy in the 1990s and the PERK study. JAMA 1990 Feb 23 263 1127-1127.

• Medline abstract (Free)

Waring GO, III et al. Results of the prospective evaluation of radial keratotomy (PERK) study 4 years after surgery for myopia. JAMA 1990 Feb 23 263 1083-1091.

• Medline abstract (Free)