Abstract
Purpose: :
To evaluate the efficacy and safety of keratotomy for post penetrating keratoplasty correction of high astigmatism using the Femtec 80kHz (Technolas Perfect Vision, Heidelberg) femtosecond laser.
Methods: :
Retrospective case study of 5 eyes of consecutive patients who underwent femtosecond laser assisted arcuate keratotomy due to high astigmatism post penetrating keratoplasty. The Femtec 80 kHz (Technolas Perfect Vision, Heidelberg) femtosecond laser was used to create paired arcuate incisions. Incisions were calculated and placed within the graft tissue to cover the steepest meridians of the preoperative corneal topography. Incisions had a depth of 85% of the local graft thickness as measured by intraoperative ultrasound. Main outcome measures were change in uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and topographically determined astigmatism.
Results: :
Mean uncorrected visual acuity (UCVA) improved from 0.94 ± 0.39 logMAR to 0.54 ± 0.29 logMAR and mean best spectacle corrected visual acuity (BSCVA) improved from 0.34 ± 0.15 logMAR to 0.32 ± 0.26 logMAR. Topographic astigmatism could be reduced from a mean baseline value of 7.74 ± 2.3 D to a postoperative value of 4.46 ± 2.3 D. No major complications occurred.
Conclusions: :
Arcuate keratotomy using the Femtec 80kHz femtosecond laser is a safe and effective procedure to reduce high astigmatism after penetrating keratoplasty. An accurate nomogram is needed to improve the predictability of the results.
Keywords: refractive surgery • astigmatism • laser