Piggyback contact lenses for reducing postkeratoplasty astigmatism.

Abstract

To the Editor. —I read with interest the article by Krachner and Fenzl entitled Surgical Correction of High Postkeratoplasty Astigmatism: Relaxing Incisions vs Wedge Resection in the AugustArchives(1980;98:1400-1402). As the authors state, high astigmatism in a clear corneal graft does not produce a good visual result. The use of surgical techniques (relaxing incisions or wedge resections) is shown to improve the refractive problem in most cases. However, I must disagree with the conclusion that relaxing incisions is the method of choice for reducing postkeratoplasty True, it may be superior to wedge resections, but Soper and Paton 1 and Caroline and Doughman 2 have shown that piggyback contact lenses can safely correct vision in eyes having high and/or irregular astigmatism. And this can be achieved with much less risk than surgery. I recently treated a 68-year-old man who had a postkeratoplasty astigmatism of 14.5 diopters in his aphakic