Radial keratotomy
 

There are radial incisions (usually four or eight) in the cornea with a clear central zone. There may be ferritin lines  at or around the incisions. Further signs: the opposite eye may have the same operation, contact lens or fine central stromal scar from photorefractive surgery. .

Questions:

1. How does radial keratotomy correct myopia?

Answer
Radial incisions (up to a depth of 90%) causes flattening of the cornea and thereby reduces the radius of curvature of the cornea. The amount of correction (ie. the refractive effect)  is determined by the depth, length and number of  cuts.

2. What other surgical procedrues may be used to treat myopia?

Answer
Excimer laser - this may be photorefractive keratotomy or LASIK. The laser excises tissue centrally and thereby flattens the central zone of the cornea and reduces the refractive power of the cornea. The outcome can be affected by stromal scarring.

Epikeratophakia - this invovles resuturing of a pre-processes, freeze-dried lenticule of humna corneal tissue onto bare Bowman's layer of the recipient cornea. Graft rejection does not occur as there is no viable donor cells but the result is unpredictable.

 

Keratomileusis - in this operation no donor lentiucle is used instead the anterior stroma tissue of the patient is removed and reshaped to a flatter configuration on a cryolathe and then reatteched to the host bed.

3. Would you advise radial keratotomy for a boxer with myopia and why?

Answer
No. Radial keratotomy weakens the cornea by cutting the cornea up to a depth of 90%. Consequently, any trauma to the eye can easily cause cornea perforation.

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Corneal perforation in a patient who had had radial keratotomy
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