Two patients with retinal detachment had antaomic restoration following scleral buckling with episcleral silicone rubber sponges. Severe, irregular, corneal astigmatism was induced, with marked reduction in visual acuity, metamorphopsia, and dissocciative exotropia with diplopia. After removal of the sponges, the corneas reverted toward normal, with improvement in visual acuity and alleviation of symptoms. Moderate degrees of regular astigmatism have persisted.