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First Author: C.Chierego ITALY
Co Author(s): M. Cargnoni R. Bellucci
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Post-keratoplasty astigmatism is still a common problem decreasing vision in operated patients. High astigmatism cannot be treated by lasik, requiring arcuate incisions. We report the results of arcuate incisions using the Victus femtosecond laser in a group of eyes, compared with arcuate incisions using the Hanna arcitome in a second group of eyes previously operated.
Ophthalmic Unit, Hospital and University of Verona, Italy
Five eyes of 5 patients with post-keratoplasty astigmatism of 6-15 D were operated with a Victus femtosecond laser. Arcuate incisions at 400 ? depth were performed, centred on the steepest meridians. Optical zone was 6 to 7 mm, and length was 70Ḟ to 90Ḟ according to the manifacturers nomogram. Obtained corneal flattening and visual acuity were analyzed and compared with 8 eyes operated with the Hanna arcitome in previous years, with astigmatism 5-17 D. Intra and post-operative complications were also analyzed and compared.
At surgery, the incisions could be located contentrically to the donor button with the femtosecond laser, and concentrically to the limbus with the Hanna arcitome. As a result, one incision was performed in the recipient corneal rim in one eye operated with the arcitome. Post-operatively, one eye after femtosecond laser and two eyes after Hanna arcitome developed keratitis that required topical antibiotics for two weeks. Two eyes after arcitome required incision suturing because of excessive corneal flattening. Corneal astigmatism after 6 months ranged 2-7 D after femtolaser, and 1-10 D after arcitome. Corrected visual acuity improved in 5/5 eyes after femtolaser, and in 4/8 eyes after Hanna arcitome.
Femtosecond laser arcuate incisions were superior to Hanna arcitome arcuate incisions in this small study. Although good results can be obtained with either technique, the femtosecond laser allows to adapt surgery to the specific eye features, and with lower postoperative problems.