[Long-term stability of astigmatism outcome after arcuate lamellar keratotomy. 3-year results of a prospective study].
BACKGROUND
The correction of low to moderate astigmatism is possible today by means of photoablation (PRK), while the treatment of moderate and higher astigmatism still involves refractive keratotomy. Experience has shown that cataract surgery, using modern tunnel techniques with self-healing incisions, results in earlier stability in both the refractive outcome and wound healing. In this study, we attempted to combine the advantages of lamellar keratotomy with those of a pair-wise T-incision as arcuate lamellar keratotomy (ALK).


METHODS
The clinical outcome of 41 patients who underwent ALK was investigate in a prospective study over a period of 3 years. The pre- and postoperative investigations undertaken included the measurement of astigmatism using a Zeiss keratometer, uncorrected visual acuity, and corrected glare vision using a Humphrey autorefractor. All patients had astigmatism between 2.0 and 7.0 D. Together with a uniform arcuate incision, we used 7 mm (n = 26) and 8 mm (n = 15) mm zones for correction.


RESULTS
The average preoperative astigmatism was 4.01 +/- 1.90 (median, 3.50) D. After a 3-year follow-up the average postoperative astigmatism was 1.59 +/- 1.29 (median, 1.38) D. The astigmatic change induced (Jaffé) after 3 years was about 3.23 +/- 2.23 (median, 3.16) D. The average uncorrected visual acuity (log MAR) before ALK was 0.20 +/- 0.12 (median, 0.22) and after follow-up, 0.41 +/- 0.14 (median, 0.39). Corrected glare vision before surgery was 0.23 +/- 0.19 (median, 0.10) and afterwards, 0.25 +/- 0.22 (median, 0.14).


CONCLUSIONS
Arcuate lamellar keratomy (ALK) stood the test as a routine clinical procedure for correction of moderate astigmatism with stable postoperative functional outcomes. We did not find impairment of glare vision following this procedure.
Nordwald
K
K
Augenklinik der Charité am Virchow-Klinikum der Humboldt-Universität zu Berlin.
Anders
N
N
Walkow
T
T
Pham
D T
DT
D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000175:diagnosis / Q000601:surgery*; D003315:Cornea / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D012029:Refraction, Ocular