J Korean Ophthalmol Soc.  2019 Oct;60(10):946-952. 10.3341/jkos.2019.60.10.946.

Long-term Results of Arcuate Keratotomy in Femtosecond Laser-assisted Cataract Surgery

• Bang CW
• Choi JW
• Han SY

• KMID: 2460512
• DOI: http://doi.org/10.3341/jkos.2019.60.10.946

Abstract

PURPOSE
To investigate the long-term follow-up results of arcuate keratotomy in femtosecond laser-assisted cataract surgery.
METHODS
The medical records of 78 patients (99 eyes) with corneal astigmatism >0.5 diopters (D) who underwent arcuate keratotomy concurrent with femtosecond laser-assisted cataract surgery were retrospectively reviewed. Uncorrected and corrected visual acuities and keratometric and higher order aberration outcomes were compared preoperatively and 2 years postoperatively.
RESULTS
The mean uncorrected visual acuities and corrected visual acuities changed from 0.55 ± 0.31 D and 0.33 ± 0.26 D, preoperatively to 0.13 ± 0.19 D and 0.07 ± 0.09 D, 2 years postoperatively. The mean preoperative corneal astigmatism was −1.15 ± 0.66 D. This was reduced to −0.79 ± 0.38 D at 1-2 days after surgery (p < 0.001), followed by no significant change for 2 years. The mean target-induced astigmatism was 1.15 ± 0.66 D preoperatively, and the mean surgically-induced astigmatism and difference vector were 0.69 ± 0.43 D and 0.83 ± 0.48 D, 2 years postoperatively. The mean correction index was 0.68 ± 0.45, 2 years postoperatively. There was no significant difference in higher order aberrations except 4 mm and 6 mm total higher order aberrations and 6 mm trefoil between preoperatively and 2 years postoperatively.
CONCLUSIONS
Arcuate keratotomy concurrent with femtosecond laser-assisted cataract surgery is a safe and effective way to reduce corneal astigmatism which remained stable over 2 years of follow-up with below moderate astigmatism.

Keyword

Arcuate keratotomy; Astigmatism; Corneal cylinder; Femtosecond laser; Higher order abberation

MeSH Terms

Astigmatism
Cataract*
Follow-Up Studies
Humans
Lotus
Medical Records
Retrospective Studies
Visual Acuity

Figure

• 

  Figure 1 Preoperative and postoperative UCVA (logarithm of minimal angle of resolution, logMAR) and BCVA (logMAR) with standard deviation. Large improvement was shown at 1–2 days and maintained without significant change for 2 years. UCVA = uncorrected visual acuity; BCVA = best corrected visual acuity; Preop. = preoperative; mo = months; yr(s) = year(s).

• 

  Figure 2 Preoperative and postoperative corneal astigmatism (diopter) with standard deviation. Significant improvement was shown at 1–2 days and maintained without significant change for 2 years. Wilcoxon signed rank test was used to examine statistical difference. Preop = preoperative; mo = month; yr = year; yrs = years; cyl = corneal astigmatism. *Significant difference between preoperation and postoperation 1-2 days.

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  Figure 3 Distribution of corneal astigmatism at preoperative and postoperative 2 years. Rate of patients below 1.0 diopter increased at 2 years after surgery. Preop. = preoperation; Postop. = postoperation; yrs = years; D = diopter.

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  Figure 4 Scatterplot of corneal astigmatism change. Scattered dots gathered within 1.0 diopter at 2 months after surgery. Preop. = preoperation; cyl = corneal astigmatism; mon = months; D = diopter.

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  Figure 5 Scatterplot of corneal astigmatism change. Similar distribution can be seen between 2 months and 2 years. mon = months; yr = years; cyl = corneal astigmatism; D = diopter.

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