[Surgical correction of high degree corneal astigmatism]

Many patients with high-grade corneal astigmatism cannot tolerate correction with spectacles or contact lenses. In contrast to myopic patients, in these cases visual rehabilitation can only be achieved surgically. In 1990 we started to perform modified corneal T-incisions in cases with high-grade astigmatism and intolerance to glasses or contact lenses. According to the eligibility criteria for selection of patients only 12 eyes were operated on in 1990: 9 eyes were affected by congenital high-grade astigmatism (mean 5.25 D); 1 had 8.5 D astigmatism after perforating injury, keratoplasty and cataract operation; 1 had 2.5 D astigmatism after perforating injury; and 1 eye showed 5.0 D astigmatism following cataract surgery. Without exception, the astigmatism was significantly reduced, from a preoperative mean of 5.25 D to a mean of 2.0 D postoperatively. The most impressive change was the improvement of uncorrected visual acuity. No complications were observed and none of the patients complained of postoperative glare. These results have encouraged us to continue with surgical correction of high-grade corneal astigmatism.