[Arcuate keratotomy for postkeratoplasty astigmatism by femtosecond laser].
OBJECTIVE
Evaluation of the effectiveness of arcuate keratotomy performed with femtosecond laser for correction of postkeratoplasty astigmatism.


METHODS
This retrospective clinical study included 11 eyes. All cases underwent arcuate keratotomy using femtosecond laser. Outcome measures included visual acuity and endothelial cell density as well as refractive, keratometric, and topographic astigmatism. The incision depth was also evaluated by OCT-3.


RESULTS
With a mean follow-up of 7.4+/-6.7 months, uncorrected visual acuity was not modified and the mean best corrected visual acuity significantly improved from 1.68+/-1.59 lines (p=0.007). The mean preoperative refractive cylinder was 5.18+/-1.15D, decreasing to 3.41+/-1.93D (p=0.045) after laser-arcuate keratotomy. The reduction of preoperative keratometric (7.79+/-3.69D) and topographic (7.98+/-2.41D) astigmatism was higher, with a decrease to 4.81+/-2.52D (p=0.021) and 4.36+/-2.59D (p=0.005) postoperatively. Endothelial cell density was not modified after surgery. The difference between achieved and planned incision depth was -10.7+/-63.5mum. All cases were uncomplicated.


CONCLUSIONS
Arcuate keratotomies performed with the femtosecond laser were effective in reducing postkeratoplasty astigmatism and has a number of advantages over conventional techniques. However, efficacy could be improved by a more accurate nomogram.


CONCLUSIONS
Arcuate keratotomy performed with femtosecond laser is a relatively easy, safe, and effective means of treating postkeratoplasty astigmatism. Given our small sample, much larger series are needed to provide more confident estimates of astigmatism reduction proportions and to adjust correction parameters.
Hoffart
L
L
Service d'Ophtalmologie, Hôpital d'adultes de la Timone, 13385 Marseille, France. louis.hoffart@ap-hm.fr
Proust
H
H
Matonti
F
F
Baeteman
C
C
De Langlade
P G
PG
Conrath
J
J
Ridings
B
B
D001251:Astigmatism / Q000209:etiology* / Q000601:surgery*; D016039:Corneal Transplantation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D054140:Refractive Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies