ESCRS - PO512 - Minimally Invasive Stromal Arcuate Keratotomy (Misak). New Astigmatic Technique With Femtosecond For Better Ocular Surface Care.

Minimally Invasive Stromal Arcuate Keratotomy (Misak). New Astigmatic Technique With Femtosecond For Better Ocular Surface Care.

Published 2024 - 42nd Congress of the ESCRS

Reference: PO512 | Type: Free paper | DOI: 10.82333/t15v-yd03

Authors: Antonio José Mateo-Orobia* 1 , Jose Manuel Larrosa 1 , Víctor Mallén 2 , Rubén Hernández 3 , Noelia Lafuente-Ojeda 4 , Alejandro Blasco-Martínez 3

1Ophthalmology,Hospital Universitario Miguel Servet,Zaragoza,Spain, 2Hospital Universitario Miguel Servet,Zaragoza,Spain, 3Ophthalmology,Hospital Provincial Nuestra Señora de Gracia,Zaragoza,Spain, 4Anesthesiology,Hospital Universitario Miguel Servet,Zaragoza,Spain

Purpose

To describe a novel approach to open an intrastromal femtolaser-assisted arcuate keratotomy in order to minimize the secondary ocular surface damage and improve the efficacy of the relaxing corneal incisions.

Setting

We present a small case series of patients with cataract and corneal astigmatism undergoing a femtolaser assisted phacoemulsification (FLACS).

Methods

Patients with cataract and corneal astigmatism between 1 and 2 diopters underwent combined surgery of FLACS with a new design of arcuate keratotomies. Intraestromal arcuate keratotomies were performed under the epithelial subbasal nerve plexus. A small opening (<1mm) was performed at the edge of the arcuate keratotomies in order to open the corneal tunnels with the introduction of viscoelastic.

Results

All the patients reduced significantly the preoperative corneal astigmatism with good refractive results that remained stable for at least 3 months.  We did not observe any ocular surface alterations and patients did not refer any pain or discomfort other than that expected from a conventional FLACS.

Conclusions

This novel approach allows the opening of intrastromal femtolaser-assisted arcuate keratotomies with preservation of the epithelial subbasal nerve plexus and minimal corneal epithelial damage. This technique could improve the quality of life related to ocular surface symptoms associated to postoperative discomfort after astigmatism surgery in phacoemulsificacion.