To the Editor.
—I read with interest the article by Krachner and Fenzl entitled "Surgical Correction of High Postkeratoplasty Astigmatism: Relaxing Incisions vs Wedge Resection" in the August Archives (1980;98:1400-1402). As the authors state, high astigmatism in a clear corneal graft does not produce a good visual result. The use of surgical techniques (relaxing incisions or wedge resections) is shown to improve the refractive problem in most cases. However, I must disagree with the conclusion that "relaxing incisions is the method of choice for reducing postkeratoplasty astigmatism." True, it may be superior to wedge resections, but Soper and Paton1 and Caroline and Doughman2 have shown that piggyback contact lenses can safely correct vision in eyes having high and/or irregular astigmatism. And this can be achieved with much less risk than surgery.I recently treated a 68-year-old man who had a postkeratoplasty astigmatism of 14.5 diopters in his aphakic
Kohn AN. Piggyback Contact Lenses for Reducing Postkeratoplasty Astigmatism. Arch Ophthalmol. 1980;98(12):2246. doi:10.1001/archopht.1980.01020041098028