Opposite clear corneal incisions to correct pre-existing astigmatism in cataract surgery

In cataract surgery, the clear corneal incision (CCl) has a small flattenin g effect on corneal curvature, which can be used to reduce pre-existing ast igmatism (PEA). Adding an identical, penetrating CCl opposite the first one can enhance the flattening effect. The paired opposite CCls (OCCls) are pl aced on the steepest meridian axis to flatten it. One CCl is used to perfor m cataract surgery, and the opposite CCl is made to enhance the flattening effect on the cornea to modulate PEA. During the past 12 months, we have us ed 2.8 to 3.5 mm OCCls in 33 eyes with PEA greater than 2.00 diopters (D) h aving cataract surgery. The moan astigmatism correction achieved with this technique was 2.06 D. This technique is simple and effective and yields sta ble results that rival those of arcuate keratotomy. The OCCl technique has a potential application for the correction of astigmatism in general refrac tive surgery. Opposite clear corneal incision nomograms with variables such as width, length, and distance from the limbus will be needed for future a pplications, (C) 2000 ASCRS and ESCRS.