ASTIGMATIC KERATOTOMY TO CORRECT PREEXISTING ASTIGMATISM IN CATARACT PATIENTS

We evaluated three general strategies for dealing with astigmatism control following phacoemulsification with posterior chamber intraocular lens surgery: (1) a neutral wound closure to minimize surgically induced cylinder; (2) wound revision techniques to minimize residual postoperative cylinder; (3) astigmatic keratotomy incisions to treat preexisting astigmatism. With the neutral wound closure, mean postoperative keratometric cylinder averaged less than 1 diopter (D). In the presence of moderate preoperative astigmatism (1.0 D to 1.9 D), the wound revision technique tended to undercorrect, while the astigmatic keratotomy tended to overcorrect. However, the keratotomy procedure resulted in less postoperative cylinder. For cases with substantial preoperative astigmatism (≥ 2 D), the astigmatic keratotomy groups corrected more of the preoperative clinder, which resulted in a greater proportion of cases with less than 1 D of postoperative cylinder and a smaller proportion with more than 2 D. Results suggest that astigmatic keratotomy is a useful adjunct to correct preexisting astigmatism in cataract patients. However, this procedure as any incisional refractive surgery technique has a certain amount of inherent biological variability. © 1990, American Society of Cataract and Refractive Surgery. All rights reserved.