Irregular astigmatism after cataract surgery resulting from inadequate clear corneal incision formation

A 66-year-old woman was referred to us due to visual complaints after cataract surgery. The patient's complaints were decreased visual acuity and a localized blur in her visual field. At slit lamp biomicroscopy, an unusually long and centrally located clear corneal incision was noted. Corneal topography revealed an irregular astigmatism in the optical axis, originating from the site of the incision. The patient's visual complaints were treated by fitting a rigid gas permeable contact lens, which increased her best corrected visual acuity to 20/16. This case report demonstrated that inadvertently long and centrally located corneal incisions should be avoided during cataract surgery to prevent high levels of irregular astigmatism. RGP contact lenses can lead to successful visual rehabilitation.