Femtosecond-Laser Assisted Astigmatic Keratotomy For Treatment Of Post-Keratoplasty Astigmatim

Published 2022 - 40th Congress of the ESCRS

Reference: PP08.08 | Type: Free paper | DOI: 10.82333/r4sf-kb46

Authors: Gerald Schmidinger* ¹ , Ruth Donner ¹ , Jan Lammer ¹ , Julia Aschauer ¹

¹Ophthalmology,Medical University of Vienna,Vienna,Austria

Purpose

To evaluate femtosecond laser-assisted arcuate incisions to reduce of high levels of astigmatism after keratoplasty using a liquid patient interface platform.

Setting

Department of Ophthalmology

Medical University of Vienna.

Methods

Patients with topographic astigmatism of more than 5 diopters at least 2 months after suture removal were included in this trial. Twenty-one patients after keratoplasty (penetrating keartoplasty or deep anterior lamellar keratoplasty, DALK) that received liquid-interface femtosecond laser-assisted arcuate incisions using the Hanna nomogram for correction of post-keratoplasty astigmatism with an incision depth of 75% of corneal thickness were included in this trial. Baseline measurements were taken at least two months after the last sutures were removed. All patients received full ophthalmolic exam including corneal tomogrpahy. Three-months post-treatment measurements were used as endpoint values.

Results

The arithmetic mean pre-operative astigmatism of 7.6 diopters was reduced to 3.37 diopters. Incisions were effective in reducing the degree of astigmatism considerably, with a tendency for undercorrection (y=0.29x + 4.14), especially at higher baseline astigmatism. Four cases showed an overcorrection. However, overcorrection was not associated with adverse effects for patients. There were no perforations using the stated nomogram.

Conclusions

Femtosecond laser-assisted arcuate incisions using the Hanna nomogram appears to be an effective method for reducing high levels of post-keratoplasty astigmatism. The incision depth of 75% did not result in any cases of perforation. In most cases, correction of the remaining astigmatism is manageable with toric IOLs, toric phakic IOLs or Excimer laser treatment.