Abstract
Purpose: :
To evaluate the efficacy and safety of astigmatic arcuate keratotomies using femtosecond laser (IntraLase, AMO) for post keratoplasty astigmatism.
Methods: :
In a retrospective study, 8 eyes of 8 patients were operated by astigmatic arcuate keratotomies to manage post keratoplasty astigmatism. Surgical procedure was performed using the femtosecond IntraLase FS 2 laser (IntraLase corp.). Paired arcuate keratotomies were done on the graft button. Incision parameters were decided upon the Hanna arcitome surgical protocol. Before, 3 months, 6 months and 1 year after laser surgery, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), cylinder and keratometry values measured with the Orbscan (Bausch and Lomb) camera were assessed. Incisions were analysed using OCT Visante (Zeiss) and a confocal microscope (Confoscan4).
Results: :
In all eyes, femtosecond laser arcuate keratotomies were performed without complication. At 1 year postoperatively, mean BCVA improved from 0.54 ± 0.17 LogMAR (L) to 0.44 ± 0.23L. The difference was statistically significant (p= 0,047). Visual acuity increased for 5 eyes, remained stable for 2 eyes and decreased for 1 eye. Mean cylinder decreased significantly (p=0.001) from 10.6 ± 2.6 Dioptries (D) to 5.5 ± 3.8D. Cylinder decreased for 6 eyes, remained stable for 1 eye and increased for 1 eye. OCT Visante showed depth incisions and Confocal images showed stromal wound epithelial invasion.
Conclusions: :
Femtosecond laser astigmatic arcuate keratotomy procedure was safe and effective for treating post keratoplasty astigmatism.
Keywords: cornea: clinical science • astigmatism • laser