Manual intrastromal corneal keratotomy: An alternate encouraging approach for refractive error correction

Results of femtosecond based intrastromal astigmatic keratotomy have been reported to be encouraging for correction of Astigmatism. We report a new surgical technique-manual intrastromal corneal keratotomy (MICK) for correction of simple refractive astigmatism (-1.5 DC against the rule). The technique involves the creation of a 100 μm thickness corneal flap creation using Moria M2 evolution LSK MicroKeratome and 300 μm depth, 4 mm long manual transverse astigmatic keratotomy on both sides of the steep axis 3 mm from the pupillary center along with four incision peripheral radial keratotomy outside the optic zone (based on the mesopic pupil). The flap was repositioned and routine post-operative regimen was followed. Patient achieved 20/20 vision in both eyes post-operatively on the first day, which was maintained even at the 1 month follow-up. This simple technique could be useful as an alternative method for correction of refractive errors in patients not suitable for excimer and/or femtosecond laser treatment.