Management of Astigmatism After Corneal Trauma

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Penetrating injuries of the anterior segment and their surgical repair can significantly alter the contour of the cornea. Despite safe surgical technique and generally accurate microsurgical wound closure, some patients have unacceptably high astigmatic errors. Some of these errors are amenable to the selective removal of tight sutures, the adjustment of a continuous suture, or both. However, in a number of cases of astigmatism after repair of corneal lacerations, these methods may fail to reduce the astigmatism sufficiently, and further surgical procedures (incisional keratotomy, excimer laser photoastigmatic keratotomy, or laser in situ keratomileusis [LASIK] may be required. In this chapter, we summarize the prognostic factors and management of astigmatism after corneoscleral lacerations.
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