Severe hyperopic shift and irregular astigmatism after radial keratotomy.

Objectives: To report a case of acute high hyperopia occurring after radial keratotomy and evaluate the extent of corneal wavefront aberration with a Hartmann-Shack aberrometer.
Methods: A 45-year-old man had undergone bilateral radial keratotomy with four incisions for myopia 15 years earlier. The patient developed significant hyperopia and irregular corneal astigmatism in the left eye after the operation, reducing his best-corrected visual acuity.
Results: The best-corrected visual acuity was 20/20 (with refraction of +0.25-1.50 diopters [D] x 169) in the right eye and 10/20 (with refraction of +9.5D-3.00D x 50) in the left eye. Topography showed marked flattening of the left cornea, and simulated retinal images of Landolt C circles were distorted in the left eye.
Conclusions: This is a rare case in which radial keratotomy induced severe hyperopic shift. Wavefront analysis with a Hartmann-Shack aberrometer revealed severe irregular astigmatism with small clear zones.