Management of astigmatic keratotomy overcorrections by corneal sutures

Astigmatic overcorrection is a significant possible complication of refractive surgical procedures such as radial keratotomy, astigmatic keratotomy, and combined radial and astigmatic keratotomy. We present the results of a study in which astigmatic overcorrection was reversed by suturing the astigmatic incisions. Videokeratoscopic studies of 15 patients showed that this technique induced a wide range of central corneal steepness, thus correcting variable amounts of astigmatic overcorrection. Mean preoperative uncorrected visual acuity was 20/100 while the mean postoperative uncorrected visual acuity was 20/40. One year after surgery, 13 patients had gained two or more Snellen lines of uncorrected vision; the remaining two had no improvement. Refraction was stable in all cases. No significant complications were observed at one year postoperatively. Corneal sutures may be used safely to manage overcorrections after astigmatic keratotomy or combined radial and astigmatic keratotomy with satisfactory results, even though the predictive value of the technique is limited.