Hyperopic shift after refractive keratotomy using the Casebeer System

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Abstract
Purpose: To determine the degree of hyperopic shift following refractive keratotomy. Setting: The Werblin Center, Princeton, West Virginia. Methods: The results of 241 consecutive radial/astigmatic keratotomy procedures in 128 patients were studied. All procedures were performed using Casebeer nomograms. Refractive follow-up information was obtained for 78% of patients at 3 months (range 1 to 6 months), 1 year (range 6 to 21 months), and 3 years (range 30 to 44 months). Results: Overall, the amount of hyperopic change decreased significantly (P < .05) during the 3 year period, from +0.34 diopters (D) per year to +0.12 D per year. Eyes with more than 6.0 D of preoperative intended correction were more unstable (+0.49 D in the first year and +0.44 D in the second and third years) than eyes with less than 5.0 D (+0.27 D and +0.05, respectively). Conclusion: Because the average magnitude of the hyperopic shift was +0.6 D in the first 3 years after surgery, a slight undercorrection, -0.5 D to -0.7 D, should be the refractive endpoint for primary and enhanced refractive keratotomy surgery.