Comparison Regression Of Astigmatic Outcomes With Beveled Versus Conventional Arcuate Keratotomy During Femtosecond Laser-Assisted Cataract Surgery

The purpose of the present study was to compare the regression of astigmatism correction in eyes with femtosecond laser-assisted AKs created perpendicular to the cornea (standard AK) to those with AKs made perpendicular to the coronal plane (beveled AK). 

The Eye Institute of West Florida, Largo, USA 

This retrospective study included cataract eyes with preexisting astigmatism that had undergone femtosecond laser-assisted cataract surgery with standard AKs, created perpendicular to the cornea (LenSx; N=13) or beveled AKs, created perpendicular to the coronal plane (LENSAR; N=14). Outcome measures included mean preoperative and postoperative astigmatism and residual cylinder. Regression or progression of astigmatism was assessed as changes in the magnitude of astigmatism between the postoperative 2 weeks and 1-year visits.  

Mean preoperative anterior corneal astigmatism in the beveled AK and standard AK groups were 0.83 ± 0.29 D and 0.97 ± 0.53 D, respectively. From postoperative 2 weeks to 1 year, the change in astigmatism was lower in the beveled AK group than in the standard AK group. Correspondingly, the proportion of eyes with a change of 0.00 D and ≤0.50 D was higher in the beveled AK group (70% vs. 46% and 100% vs. 77% in beveled AK and standard AK groups). 

Femtosecond laser-assisted beveled AKs created perpendicular to the coronal plane allow the anterior cornea to slide forward in relation to the posterior cornea, and the realigned stroma heals without wound gaping or formation of the epithelial plug, reducing the risk of scarring.