title: Long-Term Outcomes of Radial Keratotomy, Laser In Situ Keratomileusis, and Astigmatic Keratotomy Performed Consecutively over a Period of 21 Years.
abstract: Purpose. To describe a case of 3 refractive procedures performed in one eye over 2 decades. Methods.
  
  
  METHODS
  Results. A 41-year-old patient presented for refractive surgery evaluation. His ocular history includes bilateral radial keratotomy performed 21 years ago for moderate myopia: spherical equivalence of -4.25 D bilaterally. Postoperative uncorrected visual acuity (UCVA) was 20/30; however, over time he developed a hyperopic shift and UCVA decreased to 20/40 in the right eye. Thus, laser-assisted in situ keratomileusis (LASIK) was performed at an outside institution 6.5 years later, and the patient had initial improvement of UCVA to 20/25. Due to a change in refractive error, the patient underwent uneventful astigmatic keratotomy 13 years after LASIK in the right eye, and 1.5 years after surgery best-corrected visual acuity was 20/25 with manifest refraction of -1.00 + 5.50 × 134°.  Conclusion. We report the outcomes and natural refractive progression in a patient who underwent three corneal refractive procedures over two decades. This case underlines the difficulties of long-term management of post-RK hyperopia and astigmatism.
authors: University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, FL 33136, USA.
authors: Priyanka
authors: P
authors: Chhadva
authors: University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, FL 33136, USA ; Ophthalmic Biophysics Center, McKnight Vision Center, Miami, FL 33136, USA.
authors: Florence
authors: F
authors: Cabot
authors: University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, FL 33136, USA ; Miami Veterans Administration Medical Center, Miami, FL 33125, USA.
authors: Anat
authors: 0000-0002-3026-6155
authors: A
authors: Galor
authors: University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, FL 33136, USA ; Ophthalmic Biophysics Center, McKnight Vision Center, Miami, FL 33136, USA.
authors: Sonia H
authors: SH
authors: Yoo