A new combined technique of Deep Intrastromal Arcuate Keratotomy (DIAK) overlayed by LASIK flap for the treatment of high astigmatism.

Abstract

Purpose: To describe a new technique combining Deep Intrastromal Arcuate Keratotomies (DIAK) and Superficial Lamellar Keratotomy (SLK) followed by excimer photoablation for management of high naturally occurring or post-keratoplasty astigmatisms.

Methods: The first procedure was performed by femtosecond laser and included DIAK and SLK, which were scheduled at 100 µm. The flap was lifted and the incisions were manually opened. One month later, the flap was relifted and an Excimer laser treatment was performed to correct the residual ametropia.

Results: A nine-eye series was retrospectively studied. The preoperative cylinder was 6.11 D ± 2.54. The mean postoperative astigmatism was 2.22 D ± 0.91. Mean correction index was 1.07 D ± 0.28. Mean best corrected visual acuity improved from 20/45 to 20/22. Mean follow-up was 5.2 months ± 3.2. No complication was observed and postoperative outcome is satisfactory.

Conclusions: In addition to higher range and good accuracy, this innovative method prevents postoperative complications as incisions respects the corneal surface, and spares corneal stroma for the correction of high astigmatism.

Keywords: 678 refractive surgery • 428 astigmatism • 683 refractive surgery: LASIK