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Plus meridian incision for secondary implantation.

We studied 25 consecutive secondary implantations with a minimum of 4 months follow-up to learn the effect on astigmatism of passing or not passing the incision through the most plus corneal meridian. Eighteen of the 19 cases having a most plus meridian incision had postoperative astigmatism of 1 diopter or less, and their average astigmatism was reduced by surgery. All six of the cases with the incision not passed through the most plus meridian had postoperative astigmatism greater than 1 diopter, and their average astigmatism was doubled by surgery. The astigmatic difference between the two patient groups was highly significant. A most plus meridian incision is recommended.