Combined astigmatic keratotomy with corneal valvular incision in the treatment of high surgical astigmatism

Background: Astigmatic keratotomy is used conventionally to correct moderat e surgical astigmatism. However, cases with very high surgical astigmatism due to wound compression can show a dramatic response to relaxing keratotom ies made in the steeper meridian. The effect obtained cannot be predicted p re-operatively by using standard nomograms, Methods: Coupled arcuate keratotomies combined wi th corneal valvular incis ions were performed in a case of high astigmatism post-cataract surgery, Results/Conclusion: Coupled arcuate keratotomies were combined with a corne al valvular incision enabled a surgical correction of nearly 9D of astigmat ism.