ESCRS - PP20.14 - Astigmatic Changes Of Intrastromal Relaxing Incision Performed During Femtosecond Cataract Surgery

Astigmatic Changes Of Intrastromal Relaxing Incision Performed During Femtosecond Cataract Surgery

Published 2023 - 41st Congress of the ESCRS

Reference: PP20.14 | Type: Free paper | DOI: 10.82333/scx6-0w57

Authors: Nitin Suhas Deshpande* 1 , VIJAY SHETTY 2 , PRAJAKTA DESHPANDE 1

1REFRACTIVE,SHREE RAMKRISHNA NETRALAYA,MUMBAI,India, 2REFRACTIVE,SHREE RAMKRISHNA NETRALAYA,MUMBAI,India;REFRACTIVE,SHREE RAMKRISHNA NETRALAYA,MUMBAI,India

Purpose

  • To study the visual and refractive outcomes in patients who
    have undergone femtosecond Laser Assisted Arcuate
    Keratotomy (FSAK) with FLACS
  • To study the refractive efficacy of FSAK and factors affecting
    refractive efficacy of FSAK.

Setting

Retrospective study of 164 eyes who underwent FLACS(LENSAR)
with arcuate cuts at Shree Ramkrishna Netralaya from year Jan 2020
to Aug 2022.

Inclusion criteria

Age Range: 40Years – 90 Years

Preoperative astigmatism from 0.5D to 1.5D

Exclusion Criteria

Corneal condition: Keratoconus, Corneal Ulcers, PUK, Corneal
Opacities,

previous ocular surgery,

severe dry eyes.

Post Lasik patient.

Methods

  • demographic data (age, gender);
  • Laterality- operated eye;
  • pre-operative vision – corrected distance visual acuity (CDVA) and corrected near visual acuity
    (CNVA);
  • corneal parameters such as K1 and K2 (along with axis), pachymetry;
  • anterior and posterior eccentricity values at @ 4, 6, 8, and 10 mm chords; arc in the FLACS procedure;
  • post operative vision – uncorrected distance visual acuity (UDVA), uncorrected near visual acuity
    (UNVA), CDVA, and CNVA;
  • post operative sphere, cylinder, and axis.
  • We also calculated the efficacy of arcuate keratotomy using the formula (1 – [post operative
    cylinder/pre operative cylinder]*100).

Results

  • POST OPERATIVE VISUAL ACUITY

Postoperative uncorrected visual acuity was substantially similar to
best-corrected visual acuity, suggesting that many patients
undergoing FSAK should be able to function postoperatively without
correctioN

  • POSTOPERATIVE CYLINDER

There was a significant reduction
in the post-operative cylinder
compared with pre-operative
cylinder (-0.61 [-0.80, -0.56] vs 0
[-0.50, 0]; p < 0.001)

  • PATIENTS WITH RESIDUAL POSTOPERATIVE CYLINDER GREATER THAN 0.5D HAD HIGHER PREOPERATIVE ASTIGMATISM AND
    LARGER ARC LENGTH
  • HIGHER PERCENTAGE OF PATIENTS WITH REFRACTIVE EFFICACY LESS THAN 100%
    WERE SEEN IN PATIENTS WITH PREOPERATIVE AGAINST THE RULE ASTIGMATISM
  • LOWER ECCENTRICITY VALUE
    IS ASSOCIATED WITH SUBOPTIMAL OUTCOME OF FSAK

Conclusions

FSEK s a reliable method to reduce preoperative corneal astigmatism

The factors associated with less than 100% post-operative efficacy
were:

  1. higher pre-operative cylinder,
  2. lower anterior eccentricity of the cornea assessed at 8 mm and
  3. Against the rule astigmatism