Long-Term Outcomes of Radial Keratotomy, Laser In Situ Keratomileusis, and Astigmatic Keratotomy Performed Consecutively over a Period of 21 Years

الملخص EN

Purpose.

To describe a case of 3 refractive procedures performed in one eye over 2 decades.

Methods.

Case report.

Results.

A 41-year-old patient presented for refractive surgery evaluation.

His ocular history includes bilateral radial keratotomy performed 21 years ago for moderate myopia: spherical equivalence of −4.25 D bilaterally.

Postoperative uncorrected visual acuity (UCVA) was 20/30; however, over time he developed a hyperopic shift and UCVA decreased to 20/40 in the right eye.

Thus, laser-assisted in situ keratomileusis (LASIK) was performed at an outside institution 6.5 years later, and the patient had initial improvement of UCVA to 20/25.

Due to a change in refractive error, the patient underwent uneventful astigmatic keratotomy 13 years after LASIK in the right eye, and 1.5 years after surgery best-corrected visual acuity was 20/25 with manifest refraction of − 1.00 + 5.50 × 134 °.

Conclusion.

We report the outcomes and natural refractive progression in a patient who underwent three corneal refractive procedures over two decades.

This case underlines the difficulties of long-term management of post-RK hyperopia and astigmatism.