Eleven eyes of six patients, who had been referred for management of irregular astigmatism after receiving crossed incisions for myopic astigmatism, had moderate to marked irregular corneal astigmatism with marked flattening in the meridians of intersecting incisions. All six patients had a decrease in best-corrected visual acuity with spectacles. after surgery. Visual acuity with spectacles was 20 40 in five of 11 eyes; with contact lenses it reached 20 40 in ten. of 11 eyes. However, two patients could not wear the contact lenses because of lens decentration caused by the marked distortion in corneal topography. Even with contact lenses, visual acuity could only be improved to 20 25 or better in six of 11 eyes.
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