Transverse keratotomy combined with spherical photorefractive keratectomy for compound myopic astigmatism

This is a report of a study of 40 eyes in which transverse keratotomy was performed in conjunction with spherical photorefractive keratectomy. The preoperative range of myopia was -1.50 to -13.50 diopters (D). The mean attempted cylindrical correction was -1.73 D (range -0.75 to -4.00). After 6 months 47.8% achieved unaided visual acuity of 6/6, 60% achieved 6/9 or better and 75% achieved 6/12 or better. The mean postoperative spherical equivalent refraction was -0.01 D at 6 months. The mean astigmatism postoperatively was 0.32 D. A group of 179 eyes with six months follow-up after photorefractive keratectomy who had not had transverse keratotomy was compared. Their mean postoperative spherical equivalent refraction was -0.07 D and mean astigmatism was 0.21 D. Uncorrected visual acuity was 6/12 or better in 93.3%. Until there is an improvement in the mechanism of the ablatable mask this combined procedure offers patients with significant astigmatism the opportunity of achieving good visual results.