This Type of Eye Surgery Can Actually Make Vision Worse - Article Health

Before there was LASIK, there was radial keratotomy—a type of eye surgery frequently performed in the 1980s and 1990s to correct nearsightedness. Back then, doctors knew it could help people see better right away, although they didn’t actually know what the long-term effects of the procedure might be.

Now, eye experts know that radial keratotomy didn’t actually solve vision problems in the long run; in fact, for many people, it made them worse. In this week’s issue of the New England Journal of Medicine, doctors describe one such case of eye surgery gone wrong—complete with a close-up photo that shows how slicing up the cornea (yes, literally) can have lasting effects.

The new report, published as part of NEJM’s Images in Clinical Medicine series, focuses on a 41-year-old ophthalmology patient whose vision had been deteriorating for the past 20 years. She’d previously been prescribed glasses, but her vision had undergone a “hyperopic shift” since then, meaning that her close-up vision had gotten worse.

A thorough exam revealed that the woman had 16 telltale incisions in her cornea: thin slices extending from the outside edges about a third of the way in toward the center. When the doctors asked, she confirmed that she’d had radial keratotomy to correct myopia (nearsightedness) 23 years before.

At the time of the procedure, the patient reported, she’d had no immediate problems. “However, the procedure is associated with a number of complications,” the authors wrote in their report. “Overlapping or excessively central incisions may lead to reduced visual acuity, and corneal scarring is associated with glare and halos.”

People who have had this procedure are also at risk for farsightedness—meaning they have trouble making out details close to them—that gets worse over time, the authors added. Occasionally, because the incisions have weakened the cornea, the eyeball can rupture if it’s disturbed by some type of trauma.

Laser technology and modern-day procedures like LASIK have made radial keratotomy obsolete, but the procedure “did play an important role in the history of refractive surgery,” according to the American Academy of Ophthalmology.

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