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The astigmatism challenge: outcomes of femtosecond laser cataract surgery with toric intraocular lenses and arcuate keratotomy

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Session Details

Session Title: Challenge of Astigmatism Correction

Session Date/Time: Sunday 14/09/2014 | 17:00-18:30

Paper Time: 18:12

Venue: Capital Hall A

First Author: : C.Law CANADA

Co Author(s): :    P. You   D. Smallman   J. Kwok        

Abstract Details


Femtosecond laser cataract surgery is a rapidly growing field; however, there is no research analyzing the effectiveness of this technology in combination with astigmatism correcting modalities such as toric intraocular lenses (IOLs) or arcuate keratotomies (AK). Our study reports the operative and visual outcomes in an initial series of eyes undergoing femtosecond laser cataract surgery with implantation of a toric IOL or simultaneous arcuate keratotomy.


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All eyes undergoing femtosecond laser cataract surgery and toric IOL implantation (FT group) or femtosecond laser guided arcuate keratotomy with non-TORIC IOL implantation (FAK group) between January and December 2013 were enrolled in the study. The control group consisted of a retrospective age-, and sex-matched cohort of eyes that underwent manual phacoemulsification cataract surgery and toric IOL implantation (MT group) between October 2011 and December 2013. All surgeries were performed at one surgical center by a single surgeon. Visual and refractive parameters were collected pre- and postoperatively. Outcome measures included cumulative dissipated energy, operation time, corrected distance visual acuity (CDVA), and subjective refraction. Preoperative and postoperative data were compared between all groups.


Our results included 40 eyes from the FT group, 39 eyes from the FAK group, and 40 eyes from the MT group. Mean cumulative dissipated energy and mean operation time for all groups were comparable (P=0.595; P=0.124). The mean preoperative CDVA between groups were comparable (P=0.881), but postoperative CDVA were statistically significant with 0.076±0.118, 0.067±0.094 and 0.025±0.043 logMAR for FT, FAK, and MT groups, respectively (P=0.037). All groups had comparable mean preoperative and postoperative subjective sphere (P=0.577; P=0.656), cylinder (P=0.559; P=0.229) and spherical equivalent (P=0.479; P=0.721). No surgical complications occurred in any group.


Mean cumulative dissipated energy, operation time, and subjective refraction of our group of patients undergoing femtosecond laser cataract surgery with toric IOLs or AK are comparable to the manual phacoemulsification cohort of toric IOLs. A statistically significant variance was seen in the postoperative CDVA, however, a larger sample size would be required to verify if this is a true clinically significant effect.

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