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BACKGROUND: To compare the accuracy of photographic measurements to slit-lamp measurements of radial keratotomy clear zone diameters in order to develop an independent, objective, unbiased, and reproducible method of verifying clinical observations. METHODS: Twenty-five patients (48 eyes) following radial keratotomy had matched slit-lamp and photographic measurements of the diameter of the central clear cornea between the ends of opposite radial incision pairs. Matched slit-beam, photographic, and pathologic observations were compared statistically. RESULTS: Two hundred fifty-four slit-lamp clear zone diameter measurements were obtained. In twenty instances (8%), the radial incision end-point could not be identified on the photograph. For the remaining 234 measurements, the mean slit-lamp clear zone diameter was statistically smaller than the photographic measurement by 0.03 mm (/-test, ? = 2.2 x 10"5). The slit-lamp and photographic clear zone measurements were strongly positively correlated (Pearson r = 0.99, ? < 1.0 ? IO15). Matched slitlamp, photographic, and pathologic clear zone measurements (N=8) in one excised corneal button were not statistically different. CONCLUSIONS: For radial keratotomy clear zone diameters, slit-beam measurements and photographic caliper measurements yield indistinguishable results that are highly concordant over a wide range of diameters. Both slit-beam and photographic measurements yield accurate and reliable results that reflect the true pathologic achieved clear zone diameter following radial keratotomy surgery. [J Refract Surg 1998;14:331-337]
PURPOSE: To examine the variability of achieved clear zone diameters following radial keratotomy and to determine if refractive outcomes are correlated to clear zone diameter errors. METHODS: Twenty-six patients with radial keratotomy (51 eyes) were studied retrospectively. The central clear zone diameter for each radial incision meridian was measured using a slit-lamp and a photograph. The achieved clear zone diameters were statistically compared to the intended clear zone sizes and to the refractive outcomes. RESULTS: Twenty-nine of the 51 eyes met various exclusion criteria. Ninety individual slit-lamp clear zone measurements were obtained for the remaining 22 eyes. Sixty-two of 90 (69%) achieved clear zone diameters were more than 0.25 mm different than the intended clear zone size. A maximum difference of ±0.80 mm from the intended clear zone marker size was observed. The average clear zone diameter error did not statistically differ between the three refractive outcome groups (undercorrection, emmetropia, and overcorrection). CONCLUSIONS: In selected cases of centripetal radial keratotomy, the achieved clear zone diameter can vary widely from the intended clear zone size despite extensive surgeon experience. [J Refract Surg 1998;14:623-630]
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