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Year : 2017  |  Volume : 22  |  Issue : 1  |  Page : 17

Femtosecond laser arcuate keratotomy for the correction of postkeratoplasty high astigmatism in keratoconus

1 Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Ophthalmology, Ardebil University of Medical Sciences, Ardebil, Iran
3 Isfahan Eye Research Center, Feiz Hospital,Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence Address:
Habib Ojaghi
Department of Ophthalmology, Ardebil University of Medical Sciences, Ardebil
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1735-1995.200267

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Background: Astigmatism is the leading complication in visual recovery after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK); in this study, we evaluated the outcome of femtosecond laser arcuate keratotomy (FLAK) after DALK and PKP in Iranian keratoconic patients. Materials and Methods: In this prospective interventional case series, refractive and keratometric predictability, efficacy, and complications of FLAK for postkeratoplasty astigmatism in keratoconus were evaluated; 23 eyes of 23 consecutive patients (mean age of 32.43 ± 9.11 years) with high astigmatism were enrolled. The femtosecond laser performed paired 90°-angled arcuate incisions. Results: Mean logarithm of the minimum angle of resolution of corrected and uncorrected visual acuity improved from preoperative values of 0.30 ± 0.18 and 0.85 ± 0.32 to 6-month values of 0.19 ± 0.17 and 0.65 ± 0.33, respectively (P < 0.05). Mean subjective astigmatism was 7.79 ± 2.64 diopter (D) preoperatively and 3.69 ± 2.25D at 6-month after surgery (P < 0.05). Surgically induced astigmatism was 9.27 ± 5.00D. Mean refractive spherical equivalent showed no significant (P = 0.69) hyperopic shift from − 4.21 ± 4.84D preoperatively to − 2.16 ± 6.09D postoperatively. Two (8.7%) microperforations were observed. Conclusion: FLAK is a relatively safe and effective method for the treatment of postkeratoplasty astigmatism.

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