Five-Year Changes Of Corneal Astigmatism After Transepithelial Or Intrastromal Arcuate Keratotomy During Femtosecond-Assisted Phacoemulsification

Published 2024 - 42nd Congress of the ESCRS

Reference: PO1111 | Type: Free paper | DOI: 10.82333/cqvk-hp27

Authors: Mariana Domingues Vaz* ¹ , Pedro Carreira ¹ , Inês Mendo ¹ , Diogo Lopes ² , Rita Carreira ¹ , Sandra Barros ¹ , João Cardoso ¹ , Paul Campos ¹ , Inês Machado ¹ , Ana Miranda ¹ , Tomás Loureiro ¹ , Nuno Campos ¹

¹Ophthalmology ,HGO,Almada,Portugal, ²Ophthalmology ,CHBV,Aveiro ,Portugal

Purpose

To evaluate the long-term stability (5 years) of corneal astigmatism after intrastromal and transepithelial arcuate incisions (AIs) performed during femtosecond laser-assisted cataract surgery (FLACS).

Setting

Hospital Garcia de Orta

Methods

Patients with corneal astigmatism between 0.70 and 2.00 diopters (D) who underwent FLACS combined with concurrent intrastromal (IS) AIs in one eye and transepithelial (TE) AIs in the fellow eye between September 2018 and January 2019. The metric from the the 3-month and 5-year postoperative assessment were considered. The main outcome was to measure the keratometric difference over time. The variables of interest were pre and postoperative keratometric corneal cylinder (Kcyl), the percentage of overcorrection and the correction index (CI). Additional outcome was to compare the efficacy between intrastromal and transepithelial incisions.

Results

Fifteen patients (30 eyes) were included. The mean preoperative Kcyl was 0.81± 0.86 and 0.71± 0.57 in TE and IT groups, respectively (p=0.38). At 3 months of follow up, the Kcyl was 0.81± 0.86 in the TE group and 0.71± 0.57 in the IS group (p=0.21); the CI was higher in TE group (0.88 ± 0.44 vs 0.78 ± 0.35, p=0.21) and the percentage of overcorrection was higher in the TE group (33% vs. 10%). After 5 years, the mean Kycl was 0.77± 1.07 in the TE group and 1.01± 0.5 in the IS group (p=0.18), the CI was 1.15± 0.71 in TE group and 1.14± 0.58 in IS group; and the percentage of overcorrection persisted higher in the TE group (37% vs. 22%).

Conclusions

This study is one of the first reporting the long-term stability of corneal arcuate incisions in patients who underwent FLACS. Furthermore, it stands as the first study to contrast the long-term outcomes of transepithelial and intrastromal arcuate incisions, both produced by a singular laser platform. Our results show a tendency of overcorrection of preoperative astigmatism years after FLACS combined with AIs, and this was particularly evident with TE incisions.