Purpose: To report the reduction in postpenetrating keratoplasty astigmatism with the use of the microkeratome to create a lamellar corneal flap as the first stage in a two-step laser in situ keratomileusis.
Methods: The hansatome microkeratome was used to create a lamellar corneal flap in a 24-year-old man with a net corneal astigmatism of 7.3 diopters, 2 years after penetrating keratoplasty. No laser ablation was performed.
Results: The net corneal astigmatism reduced to 3.9 diopters at 1 month and 2.3 diopters at 3 months of follow-up, without any laser ablation.
Conclusion: Laser in situ keratomileusis may be performed as a two-stage procedure, because the lamellar corneal flap alone may reduce postpenetrating keratoplasty astigmatism.