title: Femtosecond-assisted astigmatic keratotomy for post-keratoplasty irregular astigmatism.
abstract: We describe the technique of femtosecond-assisted astigmatic keratotomy (AK) in a post-keratoplasty patient with irregular, nonorthogonal astigmatism. Using the keratoplasty software, an anterior arcuate side cut (400 mum thick, 6.5 mm diameter) was created using the femtosecond laser in a 68-year-old woman with irregular astigmatism 28 years after penetrating keratoplasty for keratoconus. No intraoperative or postoperative adverse events were seen during the follow-up period. Six months after the procedure, the uncorrected visual acuity improved from 20/60 to 20/50 and the best spectacle-corrected visual acuity, from 20/50 to 20/32. The mean manifest astigmatic correction decreased from 4.00 diopters (D) to 0.50 D; corneal topography showed a significant improvement in irregular astigmatism. The technique of femtosecond-assisted AK is simple and efficient for managing irregular and nonorthogonal astigmatism in post-keratoplasty patients and may overcome the limitations of earlier techniques.
authors.affiliation: Corneal and External Diseases Department, Bascom Palmer Eye Institute, Miami, Florida, USA. kymionis@med.uoc.gr
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: Sonia H
authors.initials: SH
authors.lastname: Yoo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ide
authors.forename: William W
authors.initials: WW
authors.lastname: Culbertson
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D053685:Laser Therapy; D054018:Lasers, Excimer; D011183:Postoperative Complications; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology