Combined toric intraocular lens implantation and relaxing incisions to reduce high preexisting astigmatism

To evaluate whether combining toric intraocular lens (IOL) implantation with astigmatic keratotomy (AK) can correct higher levels of astigmatism while minimizing undue effects on the optical qualities of the cornea.St. Luke's Cataract and Laser Institute, Tarpon Springs, Florida, USA.Thirteen eyes with corneal astigmatism greater than 2.50 diopters (D) (mean 5.54 D) had implantation of a Staar toric IOL combined with AK.All eyes had less than 1.00 D of refractive astigmatism postoperatively. Sixty-nine percent achieved an uncorrected visual acuity of 20/40 or better, and no patient lost best corrected visual acuity.Implanting a toric IOL in patients with high astigmatism reduced the amount of incisional surgery required. Combining techniques can correct all or most of even very high astigmatism (>5.00 D) while avoiding induced corneal irregularities.