Femtosecond laser-assisted arcuate keratotomy for correction of postkeratoplasty astigmatism

Abstract

Purpose The aim of this study was to evaluate the effect of femtosecond laser-assisted arcuate keratotomy (FS-AK) for correction of postkeratoplasty astigmatism.Patients and methods This is an interventional prospective clinical study that included 15 patients with postkeratoplasty corneal astigmatism more than 4 D for whom FS-AK was performed between January 2016 and September 2019 for correction of astigmatism. Femtosecond laser was used to perform paired arcuate incisions 1.00 mm inside the graft. Patients’ uncorrected visual acuity and astigmatic change were recorded with follow-up of up to 6 months after surgery.Results The mean magnitude of corneal astigmatism improved from 8.18±2.11 D preoperatively to 3.31±1.18 and 4.00±1.29 D at 2 and 6 months after FS-AK, respectively (P=0.000), with a significant improvement in uncorrected visual acuity from 0.72 LogMAR preoperatively to 0.36 and 0.38 LogMAR at 2 and 6 months, postoperatively (P=0.000). However, surgically induced astigmatism was 5.05±1.31 and 4.43±1.26 D at 2 and 6 months, postoperatively.Conclusion FS-AK is an effective and safe technique in reducing astigmatism following keratoplasty and in improving the visual outcome. Although regression may occur, the visual outcome is still satisfactory.