Ashkan M. Abbey, BA, Takeshi Ide, MD, PhD, George D

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Femtosecond-assisted Astigmatic Keratotomy

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Presentation transcript:

Femtosecond Laser-Assisted Astigmatic Keratotomy for Naturally Occurring Astigmatism Ashkan M. Abbey, BA, Takeshi Ide, MD, PhD, George D. Kymionis, MD, PhD, Sonia H. Yoo, MD Sonia H. Yoo, MD has received honoraria from AMO, Carl Zeiss Meditec, and Alcon.

Purpose To evaluate the results of femtosecond laser-assisted astigmatic keratotomy (FSAK) for naturally occurring high astigmatism.

Methods   Two arcuate incisions on the steepest meridians of the cornea were performed using an IntraLase® femtosecond laser in a consecutive series of 9 patients (13 eyes) with naturally occurring high astigmatism.

Methods The femtosecond laser settings were determined using a modified Lindstrom nomogram. Age: 32 to 86 years (54.46 ± 17.50 years) Follow-up: 5 to 13 months (Mean 9.8 months) A retrospective review evaluated femtosecond laser settings, uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), manifest refraction, and corneal topography.

FSAK Nomogram

UCVA Improved in 12 out of 13 eyes (92.3%) Pre-FSAK UCVA: 20/25 or worse in all eyes (range from count fingers to 20/25) Latest Follow-up Post-FSAK: All 13 eyes 20/60 or better (range from 20/60 to 20/20)

BSCVA Unchanged or improved in 10 eyes (76.9%) Pre-FSAK BSCVA: 20/40 or better in all eyes (range from 20/40 to 20/20) Latest Follow-up Post-FSAK: All 13 eyes 20/30 or better (range from 20/30 to 20/20)

UCVA and BSCVA

Astigmatism Change ∆ P Manifest cylinder decreased by more than 3 D in 10 out of 13 eyes (76.9%) Induced axis change was less than 30 degrees in 9 eyes (69.2%) Corneal cylinder decreased by more than 3.00 D in 9 eyes (69.2%)

Doubled-Angle Plots Preoperative Postoperative

Regression Analysis: Preoperative Cylinder in Keratoplasty Mode Eyes R=0.975, P=0.001

Conclusions FSAK in patients with naturally occurring high astigmatism appears to be a safe and effective technique for the reduction of astigmatism. The femtosecond laser is able to perform uniform corneal incisions with precision and a high degree of predictability.