Refractive outcomes of femtosecond laser–assisted secondary arcuate incisions in patients with residual refractive astigmatism after trifocal intraocular lens implantations

Abstract

To evaluate the refractive and visual outcomes of arcuate incisions performed with the femtosecond laser in patients with a residual refractive astigmatism after refractive lens exchange (RLE) with trifocal intraocular lenses (IOLs). EuroEyes Clinical Group, Hamburg, Germany. Retrospective interventional case series. Pseudophakic patients with remaining refractive astigmatism after RLE with a trifocal IOL were treated with femtosecond laser-assisted corneal arcuate incisions. Patients who had a previous corneal treatment were excluded. Outcome measures were uncorrected (UDVA) and corrected distance visual acuities, manifest refraction, and a power vector analysis. The study enrolled 95 eyes of 70 patients. The mean follow-up was 5.6months±4.9 (SD). Constructing an astigmatic power vector (APV) with Jackson cross-cylinder axes at 180 degrees and 90 degrees and Jackson cross-cylinder axes at 45 degrees and 135 degrees, the mean preoperative vector length was 0.46±0.16 diopter (D). Themean postoperative APV was 0.17±0.16 D. This difference was statistically significant (P<.001). The difference between the UDVA preoperatively (0.17±0.15) and postoperatively (0.08±0.10) was statistically significant (P<.001). No intraoperative or postoperative complications were observed. Femtosecond laser-assisted corneal arcuate incisions were safe, efficient, and feasible to reduce refractive astigmatism after trifocal IOL implantation.