REFRACTIVE OUTCOME FOLLOWING RADIAL KERATOTOMY AND COMBINED RADIAL AND ASTIGMATIC KERATOTOMY

Purpose: To determine whether the visual and refractive outcomes of co mbined astigmatic and radial keratotomy (AK/RK) procedures was differe nt from that following RK for the correction of naturally occurring co mpound myopic astigmatism and spherical myopia. Setting: Private profe ssional practice, San Diego, California, USA. Methods: The computer da tabase of all incisional procedures performed by one surgeon over 10 y ears was reviewed to compare the visual acuity outcome of AK/RK and RK procedures. Enhancement procedures were excluded. Only data from the last office visits were analyzed to establish the relationship between visual acuity and type of keratotomy procedure performed. A multiple regression model was constructed, which included covariates of age, po stoperative keratometric cylinder, and postoperative refraction. Resul ts: After controlling for covariates, the AK/RK population had signifi cantly lower postoperative uncorrected. visual acuity levels than the RK population (P<.03) after one operation (prior to enhancement surger y). Conclusions: Using the nomograms for myopia correction for unenhan ced RK cases, combined AK and RK procedures appeared to reduce the exp ected visual results. Surgeons may consider modifying surgical nomogra ms to account for the expected spherical undercorrection that can occu r when myopia and astigmatism are corrected simultaneously.