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Evaluation of clear corneal incisions and laser keratotomy on corneal astigmatism in femtosecond laser-assisted cataract surgery

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Session Details

Session Title: Interactive Free Paper Session: FLACS

Session Date/Time: Sunday 06/09/2015 | 08:30-10:00

Paper Time: 09:28

Venue: Room 16

First Author: : T.Kohnen GERMANY

Co Author(s): :    F. Loeffler   K. Petermann   M. Boehm   C. Titke   M. Herzog   O. Klaproth     

Abstract Details


To describe the effect of femtosecond laser clear corneal incisions (CCI) and laser astigmatic keratotomy (LK) on the total corneal refractive power (TCRP) using Scheimpflug tomographic measurements.


Department of Ophthalmology, Goethe University Frankfurt, Germany.


In this prospective study 91 eyes of 55 patients who underwent femtosecond laser assisted cataract surgery from June 2013 to July 2014 were measured with Pentacam HR preoperatively, 1 month and 3 months postoperatively. Before surgery eyes were divided into 3 groups: Group 1 (TCRP ≤ 0.50 D) received a temporal CCI. Group 2 (TCRP 0.51 - 0.75 D) received a CCI on the steep axis and group 3 (TCRP > 0.75 D) had LK based on Wang's et al nomogram. Vector analysis based on the Holladay-Cravy-Koch formula and Alpins' method was used to determine astigmatic changes. Wilcoxon-test was performed.


Mean surgically induced astigmatism (SIA) after 3 months was 0.28 ± 0.17 D in Group 1. SIA was independent of the axis of TCRP. In Group 2 mean preoperative TCRP was 0.65 ± 0.05 D and declined to 0.48 ± 0.06 D 3 months postoperatively with mean SIA of 0.39 ± 0.25 D. Although mean TCRP in Group 3 was reduced significantly (p = 0.000) with a mean SIA of 0.74 ± 0.32 D, a mean index of success (IOS) of 1.03 ± 0.61 and a mean correction index (CI) of 0.77 ± 0.58 indicate that a moderate undercorrection occurred.


Femtosecond laser CCI induce minimal astigmatism and laser keratotomy reduces preexisting TCRP. Further research with a larger sample size of eyes is needed to create a new nomogram for femtosecond laser assisted cataract surgery

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