Transverse astigmatic keratotomy combined with phacoemulsification and intraocular lens implantation.

Transverse astigmatic keratotomy is a surgical technique to correct preoperative corneal astigmatism during cataract surgery. The operative technique is described and the results of my first 40 cases are reviewed. The average keratometric astigmatism for this group before surgery was 2.6 dipoters (D). The average reduction in astigmatism was 1.5 D, which yielded a final residual average astigmatism of 1.1 D after surgery. Cases of substantial astigmatism showed the most improvement. Less improvement was seen in cases of minimal preoperative astigmatism. No increase in net keratometric astigmatism was seen in any of the eyes studied. Minor complications were limited to several small corneal abrasions created by the front-cutting diamond blade and one late temporary wound dehiscence. The only serious complication was one case of corneal macroperforation. Recommendations for handling this complication and future high astigmatism cases are given.