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M. J. Bradley, N. Desai, S. Garg, M. Farid, R. Gaster, R. F. Steinert; Post-Operative Astigmatism in Femtosecond Laser Enabled Keratoplasty: Effect of Radial Alignment Marks. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1119. doi: https://doi.org/.
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In femtosecond laser enabled keratoplasty (FLEK) a femtosecond laser is used to cut donor and host cornea in an interlocking pattern intended to promote precise anterior-posterior tissue alignment and increased wound stability. In addition, the laser can be programmed to create radial alignment marks on both donor and host to promote more even tissue distribution, suture length and radiality. We evaluate the effectiveness of these radial marks in reducing postoperative astigmatism.
Retrospective comparison of 99 cases of FLEK with or without 12 radial alignment marks in donor and host cornea. All cases used a zig-zag incision. Postoperative astigmatism based on simulated keratometry and manifest refraction was compared at 1, 3, 6 and 9 months after surgery.
The mean postoperative astigmatism at 1, 3, 6 and 9 months is summarized in Table 1. There was no significant difference found in postoperative astigmatism comparing surgeries done with versus without radial alignment marks (all p values >0.17). Despite the surgeons' subjective sense during surgery that the radial marks assisted in achieving even tissue distribution, suture length and radiality, the data suggests no difference in outcome.
Radial alignment marks may assist in achieving even tissue distribution, suture length and radiality in FLEK, but a retrospective analysis of cases performed with and without radial marks shows no difference in postoperative astigmatism.
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