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Arcuate keratotomy using spot reflector topography for residual astigmatism after intraocular lens implantation

Poster Details

First Author: J.Soler Tomas SPAIN

Co Author(s):    G. Fuentes Paez   S. Burillo                 

Abstract Details


Report visual results with spot reflector topography based arcuate keratotomy for residual astigmatism and comparison to Orbscan data.


Private clinical practice in Barcelona, SPAIN.


Prospective case series of patients undergoing arcuate keratotomy (AK) for residual astigmatism (<2.0D) after intraocular lens (IOL) implantation (multifocal, monofocal, or toric IOL). Paired corneal incisions on the steepest angle were performed, using spot reflector topography, with a 3.2mm slit-angled ophthalmic knife. Pre and post AK data included: Time before AK, distance uncorrected and best corrected visual acuities (UCVA, BCVA: logMAR scale), subjective sphere, astigmatism & axis, spherical equivalent (SE), Orbscan (DP-3002 v.3-14.), and spot reflector topographer (SRT)(CASSINI i-Optics) mean Km, anterior astigmatism, and axis. Data was analyzed with paired t-student and Pearson correlation (p �â�‰�¤ 0.05).


Total of 50 eyes, 35 patients, 15 men, 35 women, mean age 62.9�Â�±10.9 years, time before AK 445.41�Â�±869 days, pre/post data: UCVA 0.22�Â�±0.15/0.13�Â�±0.1 (p<0.01), BCVA 0.13�Â�±0.1 /0.13�Â�±0.2(p=0.60), SE 3.1�Â�±2.03D / 0.03�Â�±0.27D (p=0.32), sphere 0.40�Â�±0.4D/0.09�Â�±0.2D (p<0.01), subjective astigmatism 0.82�Â�±0.4D/0.06�Â�±0.4D (p<0.01), SRT astigmatism1.4�Â�±0.93D/0.83�Â�±0.38D (p<0.05), SRT Km 43.50�Â�±1.6D/43.77�Â�±1.5D (p=0.63), SRT axis 93�Â�±45.90D/75�Â�±39.80D (p=0.08),Orbscan astigmatism 1.22�Â�±0.7D/1.2�Â�±2D (p=0.98), Orbscan Km 43.3�Â�±4/43.7D (p=0,89), Orbscan axis 95�Â�±48�Â�°/81.9�Â�±44�Â�°(p=0.06). Pearson correlation SRT vs. Orbscan astigmatism (R=0.90), axis (R=0.80), Km (0.93).


Arcuate keratotomy, using spot reflector topography, significantly improved UCVA while reducing subjective sphere and astigmatism. Strong correlation was recorded between SRT and Orbscan data.

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