Fig. 7. Slit-lamp photograph of buttonhole flap. The full-thickness hole was noted at the time of surgery, and photoablation was postponed. Three months later, photorefractive keratectomy was performed successfully. Residual astigmatism was addressed at 6 months after surgery with astigmatic keratectomy. Final uncorrected visual acuity was 20/40, with best corrected visual acuity of 20/20. Preoperative keratometry was 46 D.