Measurement of Radial Keratotomy Clear Zone Diameters

Abstract

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]