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Ingo Schmack, Astrid Willert; Efficacy of Femtosecond-laser Arcuate Keratotomy in Eyes with High Postoperative Keratoplasty Astigmatism. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3380.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the refractive and keratometric effect of arcuate keratotomy performed using the IntraLase femtosecond laser (Abbott Medical Optics) in patients with high postoperative keratoplasty astigmatism.
Sixteen eyes of sixteen patients (mean age 41.8 +/- 6.9 years) who presented with high degree of corneal astigmatism following penetrating keratoplasty were enrolled. Paired 90 degree angled incisions were performed at 90% depth of the corneal thickness inside the graft button using the IntraLase femtosecond laser. Angular lengths and position of the cuts were determined by analyzing the locations and extents of the steepest meridians in the topographic map. Main outcome measurements included mean change in uncorrected and best spectacle-corrected visual acuity (UCVA, BSCVA), refractive and keratometric astigmatism, spherical equivalent refraction and endothelial cell count (ECC). Follow-up visits were conducted 6, 12, and 24 weeks after keratotomy.
Postoperatively, an increase of the mean BSCVA was observed in the majority of the patients (n=12). The mean refractive astigmatism decreased by 4.50 D, whereas the mean keratometric value decreased by 3.5 D (2.5 D to 15.0 D). The mean spherical equivalent refraction did not change significantly. Major postoperative complications such as irregular astigmatism, keratitis or graft failure were absent.
Arcuate keratotomy performed with the IntraLase femtosecond laser demonstrates to be an effective, safe, and relatively predictable treatment of high postoperative keratoplasty astigmatism.
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