Complications of radial keratotomy: eyes with keratoconus and late wound dehiscence.

BACKGROUND

Radial keratotomy requires a thorough preoperative examination, including photokeratography, to detect early keratoconus.

METHODS

We compared, by light and transmission electron microscopy, the healing process of corneas from two patients after radial keratotomy.

RESULTS

Clinically, one patient had a keratoconus and gained no visual benefit from the radial keratotomy. The other patient had a spontaneous corneal perforation at one incision and a hypopyon. Histological studies showed a prolonged healing process in both eyes, with a persistent epithelial plug. Bowman's layer was also interrupted and retracted in both eyes. The inflamed cornea had deep neovascularization.

CONCLUSIONS

These observations imply that 2 years after surgery, wound healing and, therefore, refraction is not stable. The results show the inappropriateness of radial keratotomy performed on eyes with keratoconus, with the possible risk of delayed corneal perforation.