title: Correction ratio and vector analysis of femtosecond laser arcuate keratotomy for the correction of post-mushroom profile keratoplasty astigmatism.
abstract: OBJECTIVE
  To evaluate the refractive and keratometric effect of arcuate keratotomy using femtosecond technology in patients with high post-keratoplasty astigmatism with a mushroom profile.
  
  
  METHODS
  Enaim Refractive Center, Tel-Aviv, Israel.
  
  
  METHODS
  Noncomparative prospective interventional case series.
  
  
  METHODS
  The arcuate depth incision was set to 80% of the minimal graft thickness, with a 60-degree angle. The mean diameter was 5.79 mm ± 0.32 (SD) according to the graft size. Patient evaluation included logMAR corrected distance visual acuity (CDVA), refraction, keratometry (K), and a complete eye examination.
  
  
  RESULTS
  Twenty-seven eyes of 27 patients after keratoplasty surgery were included. Both uncorrected distance visual acuity and logMAR CDVA improved after surgery. The preoperative mean logMAR CDVA was 0.29 ± 0.37 (SD), which improved by 1 line (to 0.19 ± 0.10; P = .01). The mean refractive astigmatism was -8.43 ± 2.80 diopters (D) (range -4.5 to -15 D), and it declined at the 3-month postsurgical follow-up to -4.31 ± 0.23 D (P < .001) and remained stable until the end of follow-up (-3.31 ± 1.39 D; P = 1.00). The K value decreased by 1.18 D (P < .001). There were no complications or adverse effects during the follow-up period.
  
  
  CONCLUSIONS
  Arcuate keratotomies performed with the femtosecond laser showed good results. There was a more than 50% decrease in post-mushroom profile keratoplasty astigmatism as well as stability of the results over 1 year.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology (Trivizki, E. Levinger), Tel Aviv Sourasky Medical Center, Tel-Aviv, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University and the Enaim Refractive Surgery Center (E. Levinger, S. Levinger), Jerusalem, Israel. Electronic address: omertr@gmail.com.
authors.forename: Omer
authors.initials: O
authors.lastname: Trivizki
authors.affiliation: From the Department of Ophthalmology (Trivizki, E. Levinger), Tel Aviv Sourasky Medical Center, Tel-Aviv, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University and the Enaim Refractive Surgery Center (E. Levinger, S. Levinger), Jerusalem, Israel.
authors.forename: Eliya
authors.initials: E
authors.lastname: Levinger
authors.affiliation: From the Department of Ophthalmology (Trivizki, E. Levinger), Tel Aviv Sourasky Medical Center, Tel-Aviv, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University and the Enaim Refractive Surgery Center (E. Levinger, S. Levinger), Jerusalem, Israel.
authors.forename: Samuel
authors.initials: S
authors.lastname: Levinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D048988:Corneal Surgery, Laser / Q000379:methods*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology