One hundred twenty-six eyes that had undergone radial keratotomy were analyzed to assess the early changes in refractive error after surgery. Between two weeks and three months, 38% of eyes became more myopic by less than 1 diopter (D), 34% by 1.00 to 1.87 D, and 25% by 2.00 to 3.50 D. Four eyes (3%) had a decrease of 0.25 to 1.25 D. The average increase between two weeks and three months was 1.31 D (SD, 0.9 D). To decrease this change, 15 eyes were semi-pressure patched at night and treated with topical steroids for four weeks following surgery. The average change between two weeks and three months in these eyes was 0.3 D (SD, 1.0 D). This retrospective study suggests that semi-pressure patching after surgery may be useful for eyes that are undercorrected or overcorrected by less than 1 D.