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The efficacy of femtosecond laser astigmatic keratotomies combined with femtosecond laser-assisted cataract surgery

Poster Details

First Author: Y.Dong UK

Co Author(s):    T. Poole                    

Abstract Details


To evaluate the visual acuity (VA) and astigmatism outcome following astigmatic keratotomies using femtosecond laser (Femto-AK) to correct astigmatism during Femtosecond laser assisted cataract surgery (FLACS).


Eye Treatment Centre Frimley Park Hospital Frimley Health NHS Foundation Trust Camberley England United Kingdom


A retrospective case-note review of 18 eyes of 17 patients who underwent Femto-AK for the correction of astigmatism combined with FLACS (VICTUS�Â�®, Bausch & Lomb Incorporated). Femto-AK was considered in any patient with a pre-operative difference in keratometry (�Î�”K) of between 0.90 and 3.80 diopters (D), measured on biometry (IOL Master 500, Carl Zeiss). The patient�â�€�™s eye was not marked pre-operatively. Paired femto-AK was performed using the Castrop nomogram, based on an optical zone of 8.5mm, programmed for 80% stromal thickness, following femto-capsulotomy and lens fragmentation. The Femto-AK tissue bridges were manually divided in theatre to fully open the Femto-AK.


All femto-AKs were performed without any complications by 7 different surgeons. Average Femto-AK length was 50.89�Â�°�Â�±10.29�Â�° (35�Â�°-62�Â�°). Mean patient age was 78�Â�±10 years. Pre-operatively, logMAR BSCVA was 76.5�Â�±9.6 letters (65-90). All eyes achieved BSCVA > 85 letters, with improvement by 20 letters on average. 1 eye had co-existing moderate glaucoma. The pre-operative �Î�”K was 2.10 �Â�± 0.91D (0.91-3.76D). Post-operative cylinder from subjective refraction was 0.90 �Â�± 0.57D (0.25 - 2.75D, p=0.000037). Before Femto-AK, 8 eyes had with-the rule astigmatism, 8 had against-the-rule astigmatism, and 2 had oblique astigmatism. Post-operatively, 6 eyes had with-the rule, against-the-rule and oblique astigmatism, each.


Astigmatic keratotomy using femtosecond laser combined with FLACS, without prior eye marking, appears to be a safe and effective way of correcting pre-operative corneal astigmatism of between 0.90 and 3.80D.

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