title: Long-term stability of refraction after intrastromal suture correction of hyperopia following radial keratotomy.
abstract: BACKGROUND
  Our first series of nine cases using circular and interrupted sutures for hyperopia from overcorrected radial keratotomy was reported 2 years ago. Additional cases and long-term follow up with this technique are presented here.
  
  
  METHODS
  Thirteen eyes of 12 patients with symptomatic hyperopia underwent corneal suturing with pursestring and interrupted sutures and were followed for 3 years. There were six original overcorrections and seven overcorrections after reoperation. The mean preradial keratotomy refractive spherical equivalent refraction was -3.85 +/- 1.40
  
  
  RESULTS
  The mean preoperative refractive spherical equivalent was +2.55 +/- 0.93 D (range +1.125 to +5.375 D). The mean follow up after the suturing procedure was 40 +/- 14.3 months with a range of 10 to 72 months. The change in refraction following suturing procedures averaged -1.84 D, resulting in an overall correction of 72% of the overcorrection. The mean increase of postoperative central keratometric power was 1.42 +/- 0.95 D. All eyes reduction of hyperopia. Uncorrected visual acuity was improved from 0.367 +/- 0.11 (20+60) preoperatively to 0.712 +/- 0.25 (20/30+) postoperatively. The average improvement was 3.3 Snellen lines. using the visual function score to assess the effectiveness of the procedure, we found 85% (11/13) of eyes obtained excellent or good results and 15% appeared fair or poor. In the 3 years since the study began, eight eyes had follow-up data from the previous study and the present study. During this period, an average change of refraction of only -0.19 D was observed. A refractive change less than 0.50 D was observed in 62.5% of the eyes, and all of the eyes had a refractive change within 1.00 D. There were no new complications and no loss of effect during the mean 43 months of follow up for those patients.
  
  
  CONCLUSIONS
  Based on the 3-year follow up, we concluded that intrastromal pursestring and interrupted techniques are stable, safe, and effect procedures for correcting hyperopia following radial keratotomy, especially for less than +3.00 D.
authors.affiliation: Eye Institute of Utah, Salt Lake City 84107, USA.
authors.forename: W A
authors.initials: WA
authors.lastname: Lyle
authors.forename: G J
authors.initials: GJ
authors.lastname: Jin
mesh_terms: D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000503:physiopathology; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000628:therapy*; D007646:Keratotomy, Radial; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012029:Refraction, Ocular; D013536:Suture Techniques; D014785:Vision, Ocular; D014792:Visual Acuity