It was with great interest that I read the article by Vinger et al1 in the January issue of the Archives. While I appreciated their collection of data, I have some concerns about the alarmist rhetoric of their article for the following reasons:
1. More than 1 million radial keratotomies (RKs) have been performed in the United States. Vinger et al report 28 cases of ruptured globes after an extensive search of the literature and various databases. This gives a prevalence of fewer than 2.8 per 100 000 cases over several years of reporting. It would be worthwhile to ask what the prevalence of ruptured globes is in the general population. One study2 from a large urban area in Australia reported a yearly incidence rate of traumatic globe penetration and rupture of 3.6 per 100 000 cases, suggesting that the frequency of scleral rupture from blunt trauma may
Parmley VC. Ruptured Globes Following Radial and Hexagonal Keratotomy Surgery. Arch Ophthalmol. 1996;114(11):1431. doi:10.1001/archopht.1996.01100140631031
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