HYPEROPIC SHIFT AND MYOPIC REGRESSION IN A PATIENT 7 YEARS AFTER BILATERAL REFRACTIVE KERATOTOMY

PURPOSE/METHODS: To report a patient who developed hyperopic progressi on in one eye and myopic regression in the other eye following bilater al, non-simultaneous refractive keratotomy. RESULTS: Uncorrected visua l acuity improved to 20/25 and 20/25-2 in the right and left eyes, res pectively, 3 months following refractive keratotomy (one procedure in the right eye, two procedures in the left eye). The visual acuity was not stable over time and almost 8 years after surgery, uncorrected dis tance visual acuity was 20/40- and 20/200. The spherical equivalent re fraction of the right eye progressed from -0.50 diopter (D) 3 months a fter surgery to +1.25 D several years later. The left eye regressed fr om a spherical equivalent refraction of -0.75 D 3 months after the sec ond surgery to -2.50 D more than 7 years postoperatively. Slit-lamp mi croscopy disclosed deeper, opaque incisions in the hyperopic eye, and shallower and more transparent incisions in the myopic eye. CONCLUSION S: The shift toward hyperopia and myopia in an individual suggest that instability of the radial keratotomy wound may be related to local wo und healing events that are, in part, related to incision depth.