Microkeratome-induced reduction of astigmatism after penetrating keratoplasty

PURPOSE: To report the reduction in postpenetrating keratoplasty astigmatis m with the use of the microkeratome to create a lamellar corneal flap as th e first stage in a two-step laser in situ keratomileusis. METHODS: The hansatome microkeratome was used to create a lamellar corneal flap in a 24-year-old man with a net corneal astigmatism of 7.3 diopters, 2 years after penetrating keratoplasty. No laser ablation was performed. RESULTS: The net corneal astigmatism reduced to 3.9 diopters at 1 month and 2.3 diopters at 3 months of follow-up, without any laser ablation. CONCLUSION: Laser in situ keratomileusis may be performed as a two-stage pr ocedure, because the lamellar corneal flap alone may reduce postpenetrating keratoplasty astigmatism. (Am J Ophthalmol 2001;131: 507-508. (C) 2001 by Elsevier Science Inc. All rights reserved).