Mini Rk For Small Residual Myopia

To present a minimally invasive technique for small myopic residual after cataract surgery.

Radial keratotomy is a technique that was used to correct myopia in the past. It was abandoned because of the problems related to doing many incisions and with a small optical zone. We present a modification of this technique, by using a 5mm optical zone and only two radial incisions to correct up to -0.5 or -0.75 of residual myopia.

We present three eyes who underwent cataract surgery and ended up with a residual myopic result and unhappy with post op uncorrected visual accuity.

Three months after the initial surgery, the patient was taken to the OR. Under topical anesthesia, a 5mm and a 9mm optical zone was marked, using the visual axis as the center of it. The steepest axis was also marked so the incisions were made in the same axis. Intra operative pachimetry was taken to ensure pre operative paquimetry map was accurate and there was no risk for perforation. A fixed 500m blade was used to make two radial incisions in the steepest axis, from 5mm to 9mm from the visual axis. Post op drops of ketorolac, lubricants and antibiotics were prescribed.

All patients have a reduction in the residual myopia of 0.25 or 0.5D. Visual accuity was measured one week after the procedure, acheiving the desired correction. No night vision symptoms were reported. This pretty simple procedure can be done in patients that are unhappy with their myopic residual refraction and without the need of lasik touch up, leaving that option for bigger refractive surprises.

Using the steepest axis will help us not to induce any undesired astigmatism and also correcting if any residual was left.

More cases are needed to prove the stability over time and the efficacy of the technique. Its a safe technique, that can be done without any major equipment and correct residual myopia instead of doing laser correction. There was no induced aberration, the procedure was relatively simple, and because of doing only two incisions and using an optical zone of 5mm, cornea remain stable even 3 years after the procedure. Other patients not reported in this study have longer stability.

By making mini RK, we avoid problems related with prk or lasik in such minor myopic outcomes.