The Application of Femtosecond Laser–Assisted Astigmatic Keratotomy on the Correction of Asymmetric Astigmatism: A Case Series

Abstract

Purpose: To present the use of femtosecond laser–assisted astigmatic keratotomy (FSAK) with or without a toric intraocular lens (IOL) for the correction of asymmetric astigmatism. Methods: Case series and review of the literature. Results: Cases 1 and 2 showed low-grade but asymmetric astigmatism on the corneal topography. After FSAK management, which made two corneal incisions in both patients, case 1 revealed prominently reduced corneal astigmatism and manifest refraction and the astigmatic axis of case 2 became more direct. Cases 3 to 5 demonstrated higher degrees of asymmetric astigmatism and FSAK was performed with toric IOL implantation in patients with asymmetric astigmatism, creating an incision at the corneal surface with a higher amount of astigmatism. Postoperatively, the corneal astigmatism displayed considerable decrement in cases 3 to 5. No optical symptoms were reported in any cases. Conclusions: FSAK is a safe and effective method for correcting moderate asymmetric astigmatism and can be combined with toric IOL implantation. [ Journal of Refractive Surgery Case Reports. 2024;4(1):e15–e19.]