Visual and Refractive Outcomes of Femtosecond Laser–Assisted Astigmatic Keratotomy in Post-Keratoplasty Astigmatism
Purpose
To determine the refractive predictability and complication rate of femtosecond laser-enabled astigmatic keratotomy for post-keratoplasty astigmatism.
Methods
Nine eyes of nine patients underwent femtosecond-enabled astigmatic keratotomy for high astigmatism (>5 diopters) after keratoplasty.
Results
Mean follow-up was for 10.2±15.4 months. Uncorrected visual acuity improved from a mean of 1.20±0.68 logarithm of the minimum angle of resolution preoperatively to a mean of 1.03±0.73 postoperatively (P: 0.02). Best-corrected visual acuity improved from a mean of 0.46±0.96 preoperatively to 0.24±0.55 postoperatively (P: 0.57). The value of absolute astigmatism was reduced from 8.72±2.49 D preoperatively to 5.22±2.57 D postoperatively (P: 0.009). The spherical equivalent was not significantly changed (P: 0.73).The defocus equivalent was reduced by more than 2 D (P: 0.07). There were no cases of perforation, wound dehiscence, graft rejection or infectious keratitis. One eye developed a neurotrophic persistent epithelial defect (11.1%).
Conclusion
Femtosecond-enabled astigmatic keratotomy is an effective treatment for high astigmatism after keratoplasty with an encouraging refractive predictability. Future studies are required to help refine the treatment nomogram and achieve better refractive accuracy.