Pilocarpine in the management of overcorrection after radial keratotomy.
BACKGROUND
Induced hyperopia is a potential complication of radial keratotomy with few effective treatments. We report the results of a retrospective study to evaluate the effectiveness of pilocarpine in the treatment of eyes overcorrected by radial keratotomy.


METHODS
Sixteen eyes of 14 patients, from a consecutive pool of 200 eyes who underwent radial keratotomy, had hyperopia. The patients were subsequently treated with topical pilocarpine. The patients were treated from 3 to 14 weeks (mean, 8.2 weeks).


RESULTS
The mean time of diagnosis of hyperopia was 3 weeks after the surgery (range, 1 to 12 weeks). The mean spherical equivalent of the manifest (fogging) refraction was +1.92 diopters (D) (range, +0.75 D to +5.00 D) and the keratometric power ranged from 31.25 D to 41.00 D (mean, 36.05 D). Mean uncorrected visual acuity before the treatment with pilocarpine was 20/50. After the treatment with pilocarpine, the mean spherical equivalent refraction was -0.31 D (range, -1.75 D to +0.50 D). The mean keratometric power was 38.32 D (range, 34.87 D to 43.12 D), with a mean uncorrected visual acuity at 20/25. The patients were followed for 8 to 49 weeks after treatment without pilocarpine (mean, 21 weeks). The mean spherical equivalent refraction and keratometric readings after that period were -0.71 D (range, -2.25 D to +0.25 D) and 38.33 D (range, 36.12 D to 43.12 D), respectively. All eyes in this study had more than 1.00 D of reduction of hyperopia at the conclusion of the study.


CONCLUSIONS
Pilocarpine effectively reduced overcorrections after radial keratotomy. After termination of treatment, the steepening of corneal curvature was maintained.
Laranjeira
E
E
Hospital Do Servidor Público Estadual, Department of Ophthalmology, Sao Paulo, Brazil.
Buzard
K A
KA
D000328:Adult; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000188:drug therapy* / Q000209:etiology*; D007646:Keratotomy, Radial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008916:Miotics / Q000627:therapeutic use*; D010862:Pilocarpine / Q000627:therapeutic use*; D012189:Retrospective Studies; D014792:Visual Acuity
D008916:Miotics; D010862:Pilocarpine