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Femtosecond laser-assisted arcuate keratotomies to correct post-penetrating keratoplasty astigmatism: a 24 month follow-up

Session Details

Session Title: Corneal Femtosecond

Session Date/Time: Monday 07/10/2013 | 14:30-16:30

Paper Time: 16:02

Venue: Elicium 1 (First Floor)

First Author: : L.Mosca ITALY

Co Author(s): :    L. Guccione   L. Mosca   A. Rosati   R. Fasciani   E. Balestrazzi  

Abstract Details


To evaluate the efficacy of arcuate keratotomies (AKs) performed with femtosecond laser for the correction of high astigmatism after penetrating keratoplasty (PKP). A prospective observational study was designed to examine the outcomes in terms of uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), the reduction of both refractive and topographic cylinder, the mean refractive spherical equivalent (MRSE) and surface asymmetry index (SAI).


Ophthalmic Department, Catholic University of "Sacro Cuore", "A. Gemelli" Polyclinic, Rome, Italy


24 eyes of 20 patients (15 M, 5F; mean age: 49.7 years ± 15.5 SD) with high astigmatism after successful PKP, performed for keratoconus, underwent AK assisted by a 60 kHz femtosecond laser (IntraLase, AMO, Irvine, CA, USA). Mean preoperative refractive cylinder was 5.23 diopters (D), mean preoperative topographic cylinder was 8.78 D; mean preoperative UCVA was 0.13 and mean preoperative BSCVA was 0.58; mean preoperative refractive error in spherical equivalent was 2.92 D. Mean preoperative SAI index was 3.25.


Mean postoperative UCVA was 0.26 six months after surgery, 0.27 at twelve months, 0.26 at twenty-four months; mean postoperative BSCVA was 0.75 six months after surgery, 0.67 at twelve months, 0.72 at twenty-four months. Mean postoperative SAI was 2.91 D six months after surgery, 2.95 D at twelve months, 3.00 D at twenty-four months. Mean postoperative refractive cylinder was 2.48 D six months after surgery, 1.95 D at twelve months, 1.88 D at twenty-four months. Mean postoperative topographic cylinder was 5.02 D six months after surgery, 6.06 D at twelve months, 5.34 D at twenty-four months. Postoperative MRSE was -1.86 D six months after surgery, -1.88 D at twelve months, -2.16 D at twenty-four months


The reduction of more than 50% of the preoperative topographic astigmatism showed the effectiveness of femtosecond laser assisted AK to correct astigmatic errors after successful PKP. The better results in postoperative BSCVA was probably related to the slight reduction of SAI (reduction of 11%).

Financial Interest:


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