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Session Title: Corneal Femtosecond
Session Date/Time: Monday 07/10/2013 | 14:30-16:30
Paper Time: 15:46
Venue: Elicium 1 (First Floor)
First Author: : R.Chaudhuri INDIA
Co Author(s): : N. Shroff R. Dutta
To study the safety, efficacy and predictability of Intrastromal & Penetrating Femtosecond Arcuate Keratotomy (FSAK) in reducing corneal astigmatism
Cataract & Refractive Surgery Service, Shroff Eye Centre, A-9, Kailash Colony, New Delhi 110048, India
20 eyes of 11 patients with cataract and corneal astigmatism (0.75 to 3.25 D) underwent FSAK using the AMO Advanced iFS (150 kHz) IntraLase Femtosecond Laser. All eyes underwent keratometry using both Auto-keratorefractor (Model Topcon KR8900) and IOLMaster 500 (Model Carl Zeiss IOL Advance Technology version 7.1). Topography & Corneal Thickness was assessed with the Oculus Pentacam HR (version 1.17r39) (Optikgeräte GmbH). Modified Lindstrom Nomogram was used for determining the zone diameter & angular length for the arcuate incisions. Eyes were further assigned to undergo either anterior penetrating or intrastromal arcuate cuts. All eyes were examined at 1 day, 1 week, 4 weeks and 8 weeks. Astigmatism analysis was done by vector analysis, and statistical analysis of data by SPSS for Windows 10.0.1.
The mean age of patients was 63.45 ± 10.72 yrs (40 to 82 years). The mean average K-readings was 45.51 dioptres pre-operatively, 45.45 dioptres on Day 1, 45.38 dioptres at 1 week, 45.43 dioptres at 4 weeks, and 45.52 dioptres at 8 weeks. There was no significant alteration in the mean average K values at any stage. At 8 weeks 50% of eyes had achieved a residual cylinder of 0.5 dioptres or less. 15% of eyes, which had over 2 dioptres of astigmatism, did not undergo a significant change post-operatively. The mean Correction Ratio (CR), that is the Surgically Induced Astigmatism divided by the Intended Cylinder Correction, was 0.84 (undercorrection). The mean CR was higher for the penetrating group (0.95 for 15 eyes) as compared with the intrastromal group (0.51 for 5 eyes).
Femtosecond Arcuate Keratotomy (FSAK) can safely and effectively reduce low levels of astigmatism only and cannot replace Toric IOLs. The correction appears stable over an 8 week period. There is an overall undercorrection, with Intrastromal FSAK being half as effective as Penetrating FSAK.
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