Results of the prospective evaluation of radial keratotomy (PERK) study 10 years after surgery.
OBJECTIVE
To determine the long-term effects and stability of refraction following a standardized technique of radial keratotomy for myopia in the nine-center Prospective Evaluation of Radial Keratotomy (PERK) Study 10 years after surgery.


METHODS
Radial keratotomy using eight centripetal incisions was performed to reduce myopia of -2.00 to -8.75 diopters in 1982 and 1983. A mean of 10 years later, patients underwent a standardized ophthalmic examination similar to previous study examinations.


RESULTS
Of 427 patients (793 eyes that underwent radial keratotomy), 374 patients (88%) (693 eyes) returned for the 10-year examination. Of 675 eyes with refractive data, 38% had a refractive error within 0.50 D and 60% within 1.00 D. For 310 first-operated eyes, the mean refractive error was -0.36 D at 6 months and changed in a hyperopic direction to + 0.51 D at 10 years. The average rate of change was +0.21 D/y between 6 months and 2 years and +0.06 D/y between 2 and 10 years. Between 6 months and 10 years, the refractive error of 43% of eyes changed in the hyperopic direction by 1.00 D or more. The hyperopic shift was statistically associated with the diameter of the clear zone. Uncorrected visual acuity was 20/20 or better in 53% of 681 eyes and 20/40 or better in 85%. Loss of spectacle-corrected visual acuity of 2 lines or more on a Snellen chart occurred in 3% of all 793 eyes that underwent surgery. Among 310 patients with bilateral radial keratotomy, 70% reported not wearing spectacles or contact lenses for distance vision at 10 years.


CONCLUSIONS
The PERK technique of radial keratotomy eliminated distance optical correction in 70% of patients, with a reasonable level of safety. A shift of the refractive error in the hyperopic direction continued during the entire 10 years after surgery.
Waring
G O
GO
Prospective Evaluation of Radial Keratotomy Coordinating Centers, Emory University, Atlanta, Ga.
Lynn
M J
MJ
McDonnell
P J
PJ
D000328:Adult; D003315:Cornea / Q000502:physiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007646:Keratotomy, Radial; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D014792:Visual Acuity