Localized Midperipheral Corneal Steepening after Hyperopic LASIK following Radial Keratotomy
Bibliographic record
Abstract
PURPOSE: To describe a case of localized midperipheral corneal steepening after laser in situ keratomileusis (LASIK) to correct hyperopia induced by radial keratotomy (RK) overcorrection. METHODS: A retrospective case observation of an unusual case. RESULTS: Five years after bilateral RK (with eight incisions) performed out of the country, a 43-year-old woman underwent LASIK in her right eye. Preoperatively, manifest refraction was + 7.75 - 1.00 x 104. Four months after LASIK, the patient's UCVA was 20/70, manifest refraction was + 2.25 - 1.25 x 103, and LASIK enhancement with flap recutting was performed. One month later, the patient complained of a 1-day history of pain and photophobia. UCVA was 20/40, and a RK incision had opened. The eye was covered with a bandage contact lens (BCL) and TobraDex drops prescribed. The following day, the BCL was removed, and UCVA was 20/200. Four days later, the patient's UCVA was 20/25. Five and a half months after LASIK enhancement, the dehisced RK incision was closed, UCVA was 20/30, and manifest refraction was + 1.25 - 1.25 x 85. One year after enhancement, UCVA deteriorated to 20/70 with manifest refraction of - 1.00 - 1.25 x 40. Localized midperipheral corneal steepening on topography also seemed to be developing. CONCLUSION: In LASIK surgery after RK, there is an inherent weakness of the cornea. Although visual acuity after RK-induced hyperopia may be improved by LASIK, the long-term refractive stability of the procedure is uncertain. Patients who undergo such a procedure should be monitored for developing localized midperipheral corneal steepening and be informed that such a complication can occur.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".