Purpose: The purpose of this study was to report on the treatment of high astigmatism after Descemet stripping automated endothelial keratoplasty with IntraLase (IntraLase, Inc., Irvine, CA) -enabled astigmatic keratotomy (IEAK).

Methods: A 85-year-old patient with pseudophakic bullous keratopathy underwent an intraocular lens exchange and Descemet stripping automated endothelial keratoplasty surgery on his left eye. Four months after surgery, high astigmatism was treated with IEAK.

Results: Preoperative uncorrected visual acuity was 20/300 and best spectacle-corrected visual acuity was 20/100 with a refraction of -4.00 + 5.75 x 150. Seven months post-IEAK, uncorrected visual acuity was improved to 20/60 and best spectacle-corrected visual acuity 20/40-2 with a refraction of -1.50 + 2.75 x 100.

Conclusion: IEAK, as presented here, can be used for the correction of high post-Descemet stripping automated endothelial keratoplasty astigmatism.