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 longterm 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 diopters (D). 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 had 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. CONCLUSION: Based on the 3-year follow up, we concluded that intrastromal pursestring and interrupted techniques are stable, safe, and effective procedures for correcting hyperopia following radial keratotomy, especially for less than +3.00 D.