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Astigmatism Reduction Clinical Trial.

The article by Price et al 1 in the March issue of theArchivesis a welcome addition to the literature on arcuate keratotomy for astigmatism reduction. I agree with the authors' preference for recommending a nomogram that is more likely to result in undercorrections than overcorrections. However, I am puzzled by their recommendation that the original nomogram should still be used for all patients except those younger than 50 years having one 45° incision. Table 5 in the article 1 indicates that the revised nomogram predicts a greater effect and would therefore produce more undercorrections and less overcorrections than the original nomogram in most cases. For a 30-year-old man with 2 diopters (D) of astigmatism, the revised nomogram recommends two 30° incisions. The original nomogram recommends two 45° incisions. If one wishes to err on the side of undercorrection, the revised nomogram should be used when it predicts a