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George O. Waring III, MD; Michael J. Lynn, MS; Brooke Fielding, MS; Penny A. Asbell, MD; Hal D. Balyeat, MD; Elisabeth A. Cohen, MD; William Culbertson, MD; Donald J. Doughman, MD; Paul Fecko, MD; Marguerite B. McDonald, MD; Ronald E. Smith, MD; Louis B. Wilson, MD; PERK Study Group

JAMA. 1990;263(8):1083-1091.

Abstract
The Prospective Evaluation of Radial Keratotomy Study is a nine-center clinical trial of a surgical technique to reduce simple myopia by making incisions in the cornea. There were 435 patients (one eye per patient is reported) enrolled in the study with a 91% follow-up rate at 4 years after surgery. After surgery, uncorrected visual acuity was 20/40 or better in 76% of eyes. Fifty-five percent of the eyes had a refractive error within ± 1.00 diopter; 28% were undercorrected, and 17% were overcorrected by more than 1.00 D. The width of the prediction 90% interval for the refractive change was 4.42 D, indicating a lack of predictability. The refractive error was not stable in some eyes; between 6 months and 4 years after surgery, 23% of eyes had a continued effect of the surgery of more than 1.00 D. For 323 patients with both eyes operated on, 64% stated they wore no optical correction. There were few serious complications. Eleven eyes (3%) lost two or three lines of best corrected visual acuity. Two eyes developed delayed bacterial keratitis without significant loss in best corrected visual acuity.

(JAMA. 1990;263:1083-1091)

Author Affiliations
From Emory University, Atlanta, Ga (Drs Waring and Wilson and Messrs Lynn and Fielding); Mount Sinai School of Medicine, New York, NY (Dr Asbell); University of Oklahoma, Oklahoma City (Dr Balyeat); Wills Eye Hospital, Philadelphia, Pa (Dr Cohen); Bascom Palmer Eye Institute, Miami, Fla (Dr Culbertson); University of Minnesota, Minneapolis (Dr Doughman); William Beaumont Eye Clinic, Royal Oak, Mich (Dr Fecko); Louisiana State University Eye Center, New Orleans (Dr McDonald); and University of Southern California, Los Angeles (Dr Smith).

Footnotes
Prepared in the PERK Coordinating Centers, Emory University, Atlanta, Ga.

Reprint requests to the Department of Ophthalmology, Emory Eye Center, 1327 Clifton Rd, Atlanta, GA 30322 (Dr Waring).

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