Combining Toric Lenses with AK or LRI

In cases where the amount of astigmatism is greater than that which can be corrected with a toric lens, such as this case of 4.0 D ATR, Dr. Osher suggests supplementing with astigmatic keratotomy or limbal relaxing incisions. Once the steepest axis of curvature is identified, he makes an AK incision and a combined LRI/main incision. Torsional MICS, phaco chop, and OVDs aid in nucleus removal.

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