Irregular astigmatism may occur after either AKs or LRIs; however, it is more common with AKs than with LRIs, presumably because LRIs are farther from the corneal center, thus mitigating any effects of irregular incisions. Off-axis AKs can lead to undercorrection or even worsening of preexisting astigmatism. To avoid creating an edge of cornea that swells and cannot be epithelialized, arcuate incisions and LRIs should not intersect other incisions (see Fig 3-2). Corneal infection and perforation have been reported.
Excerpted from BCSC 2020-2021 series: Section 13 - Refractive Surgery. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.