Comparison Of Residual Astigmatism After Femtosecond Laser-Assisted Cataract Surgery With Arcuate Keratotomy And Toric Intraocular Lens In Low Astigmatism

Astigmatism is a common refractive error that affects visual quality after cataract surgery. Femtosecond laser-assisted cataract surgery (FLACS) enables precise corneal modifications, facilitating astigmatic correction through arcuate keratotomy (AK) or toric intraocular lens (IOL) implantation. This study evaluates and compares the effectiveness and stability of these techniques in patients with low corneal astigmatism. The Purpose of this study is to compare residual astigmatism following femtosecond laser-assisted cataract surgery (FLACS) with arcuate keratotomy (AK) versus FLACS with toric intraocular lens (IOL) implantation in patients with low corneal astigmatism. 

The study was conducted at Laxmi Eye Hospital, Maharashtra, India. Ethics committee approval was taken for the same

This prospective, non-randomized study included 120 patients (60 per group) with preoperative corneal astigmatism of 0.75D–1.50D. Patients underwent either FLACS with AK or FLACS with toric IOL based on clinical indication. Residual refractive astigmatism, keratometric astigmatism, and visual acuity outcomes were assessed at one, three, and six months postoperatively. Vector analysis was performed to evaluate the accuracy and stability of astigmatic correction.

Both techniques significantly reduced astigmatism. At three months, there was no significant difference in residual astigmatism between the two groups. At six months, vector analysis demonstrated differences in alignment predictability and variability in astigmatic correction. Surgically induced astigmatism and long-term stability varied between techniques. Visual acuity outcomes remained comparable throughout the follow-up period. 

FLACS with toric IOL and FLACS with arcuate keratotomy were equally effective in reducing astigmatism at three months. Differences in long-term astigmatic stability and predictability were observed, as indicated by vector analysis.