Long-term refractive stability following combined astigmatic keratotomy and phakoemulsification.
BACKGROUND
To determine whether combined astigmatic keratotomy and cataract surgery induces a sustained reduction in astigmatism.


METHODS
Patients who had previously undergone combined cataract surgery and astigmatic keratotomy for naturally occurring astigmatism were identified and their notes reviewed. Mean final follow-up was 34 months (30-42 months). Fourteen eyes of 11 patients were eligible for study. Arcuate corneal incisions had been employed using the Buzard nomogram. Using power vector analysis, the post-operative refractive change at 6 months and final follow-up was determined.


RESULTS
The mean preoperative manifest cylindrical refractive error was 2.88 D (1.50-5.50 D). The mean postoperative manifest cylindrical refractive error was 1.89 and 1.79 D at 6 months and final follow-up, respectively. Power vector analysis demonstrated a significant postoperative reduction in refractive blur at 6 months and final follow-up (P = 0.006, P = 0.004, respectively): mean preoperative blur strength was 2.90 D and mean postoperative blur strength was 1.33 and 1.25 D at 6 months and final follow-up, respectively. Sustained postoperative reduction in astigmatism was noted in 12 of 14 eyes at final follow-up.


CONCLUSIONS
Astigmatic keratotomy is a well-established treatment for astigmatism. In this series, the refractive benefit from combined astigmatic keratotomy and cataract surgery is maintained for several years. No surgical complications were observed.
Kulkarni
Avinash
A
Royal Eye Unit, Kingston Hospital, Galsworthy Road, Kingston-upon-Thames, Surrey, UK. aviakulkarni@gmail.com
Mataftsi
Asimina
A
Sharma
Ash
A
Kalhoro
Ambreen
A
Horgan
Simon
S
D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D002386:Cataract / Q000150:complications; D002387:Cataract Extraction / Q000379:methods*; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D007646:Keratotomy, Radial / Q000379:methods*; D008875:Middle Aged; D018918:Phacoemulsification; D011184:Postoperative Period; D012029:Refraction, Ocular; D013997:Time Factors; D014792:Visual Acuity