Development of a nomogram for femtosecond laser astigmatic keratotomy for astigmatism after keratoplasty.
To develop a nomogram for femtosecond laser astigmatic keratotomy (AK) to treat post-keratoplasty astigmatism.



Three academic medical centers.



Retrospective interventional case series.



A review of post-keratoplasty femtosecond laser AK was performed. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, and keratometry were recorded preoperatively and 1, 3, 6, and 12 months postoperatively. The location, length, depth, and diameter of the AK incisions were recorded, and the surgically induced astigmatic correction was related to these variables using regression analysis.



One hundred forty femtosecond laser AK procedures were performed after penetrating keratoplasty (PKP) (n = 129) or deep anterior lamellar keratoplasty (DALK) (n =11), with 89 procedures (80 PKP, 9 DALK) included in the analysis. The mean CDVA improved from 20/59 (0.47 logMAR ± 0.38 [SD]) preoperatively to 20/45 (0.35 ± 0.31 logMAR) postoperatively (P = .013) (n = 46). The mean keratometric astigmatism decreased from 8.26 ± 2.90 diopters (D) preoperatively to 3.62 ± 2.59 D postoperatively (P < .0001) (n = 89). The mean refractive cylinder decreased from 6.77 ± 2.80 D preoperatively to 2.85 ± 2.57 D postoperatively (P < .0001) (n = 69). A nomogram for femtosecond laser AK to treat post-keratoplasty astigmatism was generated using regression analysis.



Femtosecond laser AK significantly improved UDVA and CDVA and significantly reduced keratometric astigmatism and refractive cylinder after keratoplasty. The nomogram generated should improve the accuracy of post-keratoplasty femtosecond laser AK.



None of the authors has a financial or proprietary interest in any material or method mentioned.
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China.
Ryan M
RM
St Clair
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China.
Anushree
A
Sharma
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China.
David
D
Huang
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China.
Fei
F
Yu
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China.
Yakov
Y
Goldich
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China.
David
D
Rootman
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China.
Sonia
S
Yoo
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China.
Florence
F
Cabot
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China.
Jason
J
Jun
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China.
Lijun
L
Zhang
From the Stein Eye Institute (St. Clair, Sharma, Yu, Jun, Aldave), David Geffen School of Medicine, University of California, Los Angeles, California, the Casey Eye Institute (Huang), Oregon Health Sciences University, Portland, Oregon, and the Bascom Palmer Eye Institute (Yoo, Cabot), University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA; the Department of Ophthalmology and Vision Sciences (Goldich, Rootman), the University of Toronto, Canada; the Refractive Center (Zhang), the Third Hospital of Dailan, Dailan, China. Electronic address: Aldave@jsei.ucla.edu.
Anthony J
AJ
Aldave
D001251:Astigmatism / Q000601:surgery*; D016039:Corneal Transplantation; D006801:Humans; D015948:Keratoplasty, Penetrating; D049451:Nomograms; D011183:Postoperative Complications; D012029:Refraction, Ocular; D012189:Retrospective Studies