Journal List > J Korean Ophthalmol Soc > v.60(10) > 1135388

Bang, Choi, and Han: Long-term Results of Arcuate Keratotomy in Femtosecond Laser-assisted Cataract Surgery

Abstract

Purpose

To investigate the long-term follow-up results of arcuate keratotomy in femtosecond laser-assisted cataract surgery.

Methods

The medical records of 78 patients (99 eyes) with corneal astigmatism >0.5 diopters (D) who underwent arcuate keratotomy concurrent with femtosecond laser-assisted cataract surgery were retrospectively reviewed. Uncorrected and corrected visual acuities and keratometric and higher order aberration outcomes were compared preoperatively and 2 years postoperatively.

Results

The mean uncorrected visual acuities and corrected visual acuities changed from 0.55 ± 0.31 D and 0.33 ± 0.26 D, preoperatively to 0.13 ± 0.19 D and 0.07 ± 0.09 D, 2 years postoperatively. The mean preoperative corneal astigmatism was −1.15 ± 0.66 D. This was reduced to −0.79 ± 0.38 D at 1–2 days after surgery (p < 0.001), followed by no significant change for 2 years. The mean target-induced astigmatism was 1.15 ± 0.66 D preoperatively, and the mean surgically-induced astigmatism and difference vector were 0.69 ± 0.43 D and 0.83 ± 0.48 D, 2 years postoperatively. The mean correction index was 0.68 ± 0.45, 2 years postoperatively. There was no significant difference in higher order aberrations except 4 mm and 6 mm total higher order aberrations and 6 mm trefoil between preoperatively and 2 years postoperatively.

Conclusions

Arcuate keratotomy concurrent with femtosecond laser-assisted cataract surgery is a safe and effective way to reduce corneal astigmatism which remained stable over 2 years of follow-up with below moderate astigmatism.

Figures and Tables

Figure 1

Preoperative and postoperative UCVA (logarithm of minimal angle of resolution, logMAR) and BCVA (logMAR) with standard deviation. Large improvement was shown at 1–2 days and maintained without significant change for 2 years. UCVA = uncorrected visual acuity; BCVA = best corrected visual acuity; Preop. = preoperative; mo = months; yr(s) = year(s).

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Figure 2

Preoperative and postoperative corneal astigmatism (diopter) with standard deviation. Significant improvement was shown at 1–2 days and maintained without significant change for 2 years. Wilcoxon signed rank test was used to examine statistical difference. Preop = preoperative; mo = month; yr = year; yrs = years; cyl = corneal astigmatism. *Significant difference between preoperation and postoperation 1-2 days.

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Figure 3

Distribution of corneal astigmatism at preoperative and postoperative 2 years. Rate of patients below 1.0 diopter increased at 2 years after surgery. Preop. = preoperation; Postop. = postoperation; yrs = years; D = diopter.

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Figure 4

Scatterplot of corneal astigmatism change. Scattered dots gathered within 1.0 diopter at 2 months after surgery. Preop. = preoperation; cyl = corneal astigmatism; mon = months; D = diopter.

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Figure 5

Scatterplot of corneal astigmatism change. Similar distribution can be seen between 2 months and 2 years. mon = months; yr = years; cyl = corneal astigmatism; D = diopter.

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Table 1

Demographics of patients

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Values are presented as mean ± standard (range) or number.

UCVA = uncorrected visual acuity; logMAR = logarithm of minimal angle of resolution; BCVA = best corrected visual acuity; D = diopter.

Table 2

Preoperative and postoperative visual acuity (logMAR)

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Values are presented as mean ± standard deviation.

logMAR = logarithm of minimal angle of resolution; UCVA = uncorrected visual acuity; BCVA = best corrected visual acuity; SD = standard deviation.

*Wilcoxon signed rank test.

Table 3

Preoperative and postoperative corneal astigmatism

jkos-60-946-i003

Values are presented as mean ± standard deviation unless otherwise indicated.

D = diopter; SD = standard deviation.

*Wilcoxon signed rank test.

Table 4

Vector analysis using Alphins method of keratometric astigmatic correction at 2 years after femtosecond-assisted combined phacoemulsification and arcuate keratotomy

jkos-60-946-i004

Values are presented as mean ± standard (range).

D = diopter; TIA = target induced astigmatism; SIA = surgically induced astigmatism; DV = difference vector; CI = correction index; SD = standard deviation.

*Student's t-test.

Table 5

The comparison of higher order abberations between preoperation and postoperation (2 months) after femtosecond-assisted combined phacoemulsification and arcuate keratotomy

jkos-60-946-i005

Values are presented as mean ± standard deviation.

tHOA = total higher order abberations.

*Wilcoxon signed rank test.

Table 6

The comparison of higher order abberations between 2 months and 2 years after femtosecond-assisted combined phacoemulsification and arcuate keratotomy

jkos-60-946-i006

Values are presented as mean ± standard deviation.

tHOA = total higher order abberations.

*Wilcoxon signed rank test.

Notes

Conflicts of Interest The authors have no conflicts to disclose.

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