Radial keratotomy: where did it go wrong?

A prospective study was set up to determine the effectiveness, predictability, stability, safety and feasibility within the National Health Service of radial keratotomy. The methods adopted include a new simplified guide to surgery with a predicted accuracy in 84 of 100 operations. Ninety-six percent of eyes with myopia of -6.0D or less preoperatively were seeing 6/12 or better six months after surgery. Refraction remained stable within a range 0.5D spherical equivalent between the first and sixth postoperative months in 96%, between the first and twelfth postoperative months in 90% and between the first and second years in 100% of eyes examined. There were no cases of progressive hypermetropia. Sixty-four percent of the 61 patients admitted to postoperative symptoms. Three percent of eyes lost best corrected vision. The disappointments were few but were analysed in detail. The least reliable were found to be associated with the higher myopes requiring a 3.0 mm clear optical zone.