PTK-Assisted Corneal Lenticule Implantation for Enhancement after RK: A Case Report

Abstract Objective To investigate the safety and efficacy of superficial corneal stromal lenticule implantation in treating patients with overcorrection after radial keratotomy (RK), and to evaluate the application value of this "additive" surgical method in the correction of refractive abnormalities after special refractive surgeries. Methods A retrospective analysis was conducted on a 52-year-old male patient who had undergone bilateral radial keratotomy (RK) 32 years earlier and experienced worsening near vision and visual fatigue over the past 3 years. Preoperative examination revealed bilateral overcorrection and age-related accommodative dysfunction. In March 2024, the right eye underwent phototherapeutic keratectomy (PTK)-assisted surface corneal stromal lenticule implantation. PTK was used to remove the corneal epithelium and smooth the surface, creating an optimal bed for the lenticule. One month later, the same procedure was performed on the left eye after satisfactory results were obtained. Follow-up assessments included corneal curvature, central corneal thickness, visual acuity, refractive power, corneal topography, and RK incision status. Results At 1-year follow-up, uncorrected distance visual acuity improved from 0.5 bilaterally to 0.3(LogMAR) in both eyes; uncorrected near visual acuity improved from 0.8 at 30 cm to 0.3 at 30 cm༈LogMAR༉. Corneal curvature and central thickness increased in both eyes. Anterior segment OCT confirmed good lenticule position, with no incision rupture, neovascularization, or adverse events (e.g., infection, rejection, lenticule displacement) observed. Conclusion Surface corneal stromal lenticule implantation—an “additive” approach distinct from traditional “subtractive” ablation—effectively corrected hyperopia after RK surgery, with stable postoperative parameters and significantly improved uncorrected visual acuity. This technique preserves the original RK incisions, theoretically reducing the risk of incision rupture and minimally impacting corneal biomechanics, thereby offering a new treatment option for patients with overcorrection after RK.