Dr. Yoo discusses the management of postkeratoplasty astigmatism, a common cause of poor visual outcomes despite clear grafts. While sutures are in, she recommends management with spectacles or contact lenses for those with < 3D, selective suture removal, and running suture adjustment. After sutures have been removed, refraction and topography should be stable (3–6 months) before any further intervention such as mechanical or femtosecond technique, wedge resection, and compression sutures.