Is hot biopsy associated with a higher rate of complications than snare polypectomy?

Abstract

To determine the refractive efficacy, predictability, stability, and complication rate of Intralase femtosecond laser–assisted astigmatic keratotomy (AK) for irregular astigmatism after penetrating keratoplasty (PKP).Ophthalmology Department, Hôtel-Dieu, Paris, France.Retrospective case series.Femtosecond laser–assisted AK was performed to treat high irregular astigmatism (>5.0 diopters [D]) after PKP. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, vector analysis, and complications were evaluated.The study evaluated 62 eyes of 57 patients over a mean follow-up of 28 months ± 3.5 (SD). Preoperatively, the mean CDVA was 0.51 ± 0.26 logMAR and the mean UDVA was 0.98 ± 0.24 logMAR; 6 months postoperatively, the mean CDVA and UDVA improved to 0.40 ± 0.22 logMAR and 0.60 ± 0.2 logMAR, respectively (both P < .01). The mean preoperative absolute astigmatism was 7.1 ± 1.72 D; 6 months postoperatively, the mean refractive astigmatism was 2.6 ± 2.4 D (P < .001). The UDVA, CDVA, and astigmatism remained stable up to the end of follow-up. The efficacy index was 0.81 at 6 months and 0.67 at 2 years. There were 2 cases of microperforation, 3 cases of infectious keratitis, 3 graft rejection episodes, and 1 case of endophthalmitis. Overcorrection occurred in 12 eyes.Femtosecond laser–assisted AK was effective in reducing irregular astigmatism after PKP. Predictability of astigmatism correction is variable over time with a decrease in the efficacy index 2 years postoperatively. Refinement of the treatment nomogram for femtosecond laser–assisted AK for high astigmatism after PKP remains a major issue.No author has a financial or proprietary interest in any material or method mentioned.