Long-term stability of refraction after intrastromal suture correction of hyperopia following radial keratotomy.
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.
Lyle
W A
WA
Eye Institute of Utah, Salt Lake City 84107, USA.
Jin
G J
GJ
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