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Radial Keratotomy (RK) – Correcting Vision Prior To Laser Eye Surgery

We are very fortunate these days to have the opportunity to benefit from several advanced laser eye procedures.  There are millions of individuals all over the world who have already benefited from the safe, accurate, and fast results that have been introduced into their lives thanks to laser eye surgery.

Although it might seem as though laser eye surgery has existed forever, actually it has only been a fairly common procedure for about 20 years.  Before laser surgery, there was a different widely used vision correction procedure that is called radial keratotomy.

Correcting Vision with Diamond Blades

Radial keratotomy involved a surgical diamond blade being used by an ophthalmologist.  That might sound scary, but thousands of individuals had this procedure performed prior to laser eye surgery being available and were very happy with the results they received.

This procedure corrected short-sightedness (myopia) only, and it involved a series of incisions being created that formed a 'radial' pattern - similar to cutting a pizza.  The deep cuts, unlike laser eye surgery, reshaped the cornea effectively.

Radial keratotomy may involve 32, 16, 12, 8, or 4 incisions being made into several different orientations and patterns that are based on a surgeon's style and training, as well as refractive errors.

In contrast to laser eye surgery, where the procedure is done on both eyes and is performed as day surgery, individuals who had the radial keratotomy procedure performed usually had to stay in the hospital overnight. The vision of one eye was corrected, and then the second eye would be corrected within a month. This left many people in the unusual position of one eye having nearly perfect or perfect vision while the other eye had blurry short-sightedness.

Radial Keratotomy History

The initial refractive surgery attempts where incisions were made in the cornea occurred during the 1930s.  That was when Tsutomu Sato, a Japanese ophthalmologist, conducted his first experiments on the posterior and anterior keratotomy.  He continued his experiments after World War II but did not achieve reliable results.

Progress next occurred as a result of an accident.  In 1974 Svyatoslav Fyodorov, a Russian ophthalmologist removed glass from a boy's eye following a bicycle accident. Upon impact his glasses shattered and glass particles lodged inside of his eye.

Fyodorov performed a surgical procedure attempting to save the boy's vision and made several radial incisions in the eye during the process, which extended into a radial pattern going from the pupil to the cornea's periphery, which ironically, were similar in form to a bicycle wheel's spokes.

Fyodorov removed the glass, and then after giving the wounds some time to heal, he re-examined the eyes and was surprised to find that the boy's vision had made a significant improvement.  His visual acuity, in fact, was better than it was prior to the accident. This discovery was the origins of the radial keratotomy procedure.

Although radial keratotomy did turn out to be very popular and reasonably successful, especially during the 1980's, the main limitation that it had was that the procedure's success relied heavily on the surgeon's skill. The procedure may have been more successful.  However, laser eye surgery proved to be a technically superior alternative.

Radial Keratotomy Recovery

To ensure proper healing, good post-surgical care was necessary.  Despite that, many individuals were eager to throw out their contact lenses or glasses, and most people did experience good visual results.

However, radial keratotomy definitely didn't have the same benefits that laser eye surgery can offer, either in the long term or short term.

What occurs later?

Individuals who have radial keratotomy performed might not have had any issues following surgery.  Some other might develop certain visual problems like night vision loss or halos.

After an individual had the radial keratotomy procedure performed, they were unable to undergo laser eye surgery after it became available. It is something they might have considered if they were not satisfied with the result they received from radial keratotomy.  However, it wasn't possible to have laser eye surgery due to the fact that both corneas top layers were incised.

Most importantly, anybody who had radial keratotomy previously and needs cataract surgery now will require surgical assistance. That doesn't mean that they can't have successful cataract surgery.  It just means that the surgeon will have to consider a number of different factors when planning the patient's surgery.

Like with anybody who has laser eye surgery performed, anybody who had radial keratotomy and is in their late 40's or 50s is going to need to use reading glasses invariably, due to presbyopia.

However, there are numerous individuals who have undergone the superseded vision correction procedure.  Although laser eye surgery does provide far superior long-term outcomes, radial keratotomy at the same was considered to be a very effective refractive procedure.