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Femtosecond Laser Arcuate Keratotomy for the Correction of Postkeratoplasty High Astigmatism in Keratoconus Publisher



Hashemian MN1 ; Ojaghi H2 ; Mohammadpour M1 ; Jabbarvand M1 ; Rahimi F1 ; Abtahi MA3 ; Mazloumi M1 ; Abtahi SH3
Authors
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Authors Affiliations
  1. 1. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Ophthalmology, Ardebil University of Medical Sciences, Ardebil, Iran
  3. 3. Isfahan Eye Research Center, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Research in Medical Sciences Published:2017


Abstract

Background: Astigmatism is the leading complication in visual recovery after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK); in this study, we evaluated the outcome of femtosecond laser arcuate keratotomy (FLAK) after DALK and PKP in Iranian keratoconic patients. Materials and Methods: In this prospective interventional case series, refractive and keratometric predictability, efficacy, and complications of FLAK for postkeratoplasty astigmatism in keratoconus were evaluated; 23 eyes of 23 consecutive patients (mean age of 32.43 ± 9.11 years) with high astigmatism were enrolled. The femtosecond laser performed paired 90°‑angled arcuate incisions. Results: Mean logarithm of the minimum angle of resolution of corrected and uncorrected visual acuity improved from preoperative values of 0.30 ± 0.18 and 0.85 ± 0.32 to 6‑month values of 0.19 ± 0.17 and 0.65 ± 0.33, respectively (P < 0.05). Mean subjective astigmatism was 7.79 ± 2.64 diopter (D) preoperatively and 3.69 ± 2.25D at 6‑month after surgery (P < 0.05). Surgically induced astigmatism was 9.27 ± 5.00D. Mean refractive spherical equivalent showed no significant (P = 0.69) hyperopic shift from − 4.21 ± 4.84D preoperatively to − 2.16 ± 6.09D postoperatively. Two (8.7%) microperforations were observed. Conclusion: FLAK is a relatively safe and effective method for the treatment of postkeratoplasty astigmatism. © 2017 Journal of Research in Medical Sciences.
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