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Correction of astigmatism in cataract surgery: femtolaser arcuate incisions or tangential keratotomy?

Poster Details

First Author: M.Tyazhev RUSSIA

Co Author(s):    M. Shanturova   T. Iureva                 

Abstract Details


To evaluate the effectiveness of astigmatism correction in cataract phacoemulsification using one-stage tangential keratotomy and femtolaser corneal arcuate incisions.


S. Fyodorov Eye Microsurgery Federal State Institution, Irkutsk, Russia


Comparative analysis of pre- and postoperative results was carried out in 2 clinical groups, formed depending on method of astigmatism correction. The first group consisted of 40 patients at age of 60.7±8.2 years in combination with corneal astigmatism 2.58±0.27 D. For astigmatism correction they underwent tangential keratotomy. The second group consisted of 35 patients aged 58.8±8.4 years in combination with corneal astigmatism 2.74±0.28 D, for treatment of astigmatism, the method of applying corneal arcuate incisions was used with femtosecond laser. In the second stage, all patients underwent phacoemulsification of cataracts, and hydrophobic monofocal lenses were implanted.


As result of combined operation, uncorrected visual acuity restoring was observed up to 0.42±0.03 and 0.39±0.03, corrected visual acuity - to 0.65±0.03 and 0.68±0.03 in 1 and 2 groups respectively. Magnitude of corneal astigmatism decreased in patients of first group from 2.58±0.27D to 0.79±0.04 and from 2.74±0.28D to 0.78±0.04D in patients of second group. In 85.5% of cases of simultaneous combined surgery in both groups, it was possible to reduce astigmatism to physiological value. In 14.5% of cases in patients with astigmatism exceeding 2.5D this operation allowed compensating astigmatism up to 1.5D.


Thus, postoperative results suggest that both methods are effective for correcting first degree astigmatism. Advantage of keratotomy is simplicity and lack of the need for additional equipment. However, in this operation, it is very difficult to predict refractive effect. In addition, experience of the surgeon is of no small importance, which allows avoiding corneal perforation. Femtotechnology ensures the safety of operation. Use of a femtolaser allows the corneal incisions to be precise in depth and length, as a result of which this technique can be used by surgeons who do not have sufficient experience in surgery.

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