Transverse keratotomy to correct high corneal astigmatism after cataract surgery

To assess the outcome of transverse keratotomy to correct high corneal astigmatism after cataract surgery.

Vall d'Hebron Hospital, Department of Ophthalmology, Cornea and Refractive Surgery Unit, Barcelona Autónoma University, Spain.

Thirty-two eyes with regular corneal astigmatism between 2.50 and 5.00 diopters (D) after previous cataract surgery had two transverse incisions with an optical zone of 5.0 or 7.0 mm, a depth of 80 or 90%, and a length of 3.0 or 4.0 mm, depending on the amount of astigmatism and based on a personal nomogram we developed.

From 80 to 100% of the desired correction was achieved in 38.7% of eyes and from 60 to 80% in 38.9%. At 6 months, only 9.1% had a keratometric change of more than 0.50 D. Best corrected visual acuity was the same or better in 85.2% of patients; no patient lost more than one Snellen line.

This easy, safe technique had low anatomical and refractive morbidity and high efficacy, making it an excellent option for eyes with high astigmatism after cataract surgery. More research is required in view of the considerable unpredictability of our results and the disparity in methods and results of other published studies.