Correction of high astigmatism using LASIK and arcuate keratotomy

We describe the case of a 47-year-old man who came to our center to be assessed for refractive surgery in 2007. The initial scan (instillation of 3 drops of cyclopentolate 1%) revealed a corrected distance visual acuity of 20/60 with +0.50 –9.50 × 10° in OD and 20/60 with +1.25 –9.50 × 165° in OS. We performed laser in situ keratomileusis (LASIK) in both eyes using a bicylindrical approach after marking the horizontal axis using the slit lamp. Six months later, residual astigmatism was treated with arcuate keratotomy in both eyes. To the best of our knowledge, LASIK has not been previously applied in a patient with such a high degree of astigmatism. In addition, no complications were observed and the patient was satisfied with the outcome of treatment.