A combined incision technique of radial keratotomy. A comparison to centripetal and centrifugal incision techniques in human donor eyes.
OBJECTIVE
To evaluate and compare the extent of corneal flattening and the anatomy of the incision grooves produced by centrifugal, centripetal, and combined incisions in a human donor eye model.


METHODS
Twenty-seven eyes, divided into three groups of nine, received eight-incision radial keratotomy using the centrifugal, centripetal, or combined incision technique. Corneal curvature was evaluated using a topography system, and the anatomy of the incision was assessed by light microscopy and scanning electron microscopy.


RESULTS
The average central corneal flattening at the 3-mm clear zone was 4.16 +/- 1.47 diopters (D) for centrifugal incisions; 7.71 +/- 2.77 D for centripetal incisions; and 9.26 +/- 1.75 D for combined incisions. The difference in corneal flattening between eyes that received centrifugal versus either centripetal or combined incisions was significant (P < 0.01), whereas the difference between combined and centripetal incisions was not significant (P = 0.174). Anatomic differences were observed within the incision grooves produced by the three techniques.


CONCLUSIONS
The authors describe a novel combined incision technique of radial keratotomy that provides the potential safety of a centrifugal incision with the effect of a centripetal incision.
Assil
K K
KK
Anheuser-Busch Eye Institute, St. Louis University School of Medicine, Department of Ophthalmology, MO 63104.
Kassoff
J
J
Schanzlin
D J
DJ
Quantock
A J
AJ
D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000502:physiology / Q000601:surgery* / Q000648:ultrastructure; D005069:Evaluation Studies as Topic; D006801:Humans; D007646:Keratotomy, Radial / Q000379:methods*; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D014019:Tissue Donors