Using paired full-thickness incisions to treat corneal astigmatism is an established technique that has been used for many decades. We have previously reviewed the technique and even provided a suggested nomogram for your own patients. The main phaco incision is placed on the steep axis of the cornea and then a second incision is made 180 degrees opposite. This causes flattening of this meridian and then a corresponding steepening 90 degrees away. This additional incision is typically not used during the cataract surgery since its function is purely for astigmatism purposes. Because this incision stays pristine, without instruments entering and exiting, it seals very well and usually does not even require corneal stromal hydration to be watertight and closed.
click below to learn about this technique and the sealing of these incisions: