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September 1993

Updating Keratospeak IV

Author Affiliations

Houston, Tex

Arch Ophthalmol. 1993;111(9):1166. doi:10.1001/archopht.1993.01090090016003

The article by Waring1 in the October 1992 issue of the Archives is a remarkably clear and complete compendium of refractive surgical procedures. In anticipation of "Keratospeak V," I would like to offer the following amendments to "Keratospeak IV."

Section I.B.2.d.i. can be enhanced by including other measures taken at the time of cataract surgery to reduce or minimize postoperative astigmatism. I would rewrite this section as follows:

d. Modification of cataract surgery

i. Intraoperative

—Astigmatism-neutral cataract incision

—Manipulation of incision to reduce preexisting astigmatism2

Adjust wound size according to preexisting astigmatism

Center incision along steep meridian

Scleral flap recession or resection3

—Transverse keratotomy

Section I.C.1.a. can be revised as follows to add a third laser modality to photorefractive keratectomy:

iii. Erbium-YAG laser (2.9 μm).

Section I.C.1.c. is more correctly written in the following fashion:

c. Intrastromal photodisruption or photorefractive keratectomy

  1. Picosecond Nd-YLF laser (1053 nm)