IntraLase-Enabled Astigmatic Keratotomy for Post-Keratoplasty Astigmatism: On-Axis Vector Analysis

Femtosecond Laser-Assisted Astigmatism Correction

“…For all cases, incision depth was 90% and incisions were placed at 0.5 mm within graft-host junction. Overcorrection was noted initially which led the authors to adjust the incision arc length: 40º to 60º for up to 6 D, 65º to 75º for 6 to 10 D, and 90º for >10 D of astigmatism (Kumar et al, 2010). Similarly, using the Technolas FS ® laser system, which allows for deeper incision depth, Nubile et al treated 12 post-keratoplasty eyes with incision depth of 90% and arc length of 40º to 80º within 1 mm of the graft-host junction.…”

“…This novel technique has been primarily described in treating high astigmatism following penetrating keratoplasty incisions (Buzzonetti et al, 2008;Harissi-Dagher & Azar, 2008;Kiraly et al, 2008;Kumar et al, 2010). Preoperative evaluation should include a comprehensive examination, manual keratometry, pachymetry, and corneal topography.…”

“…After adjusting the treatment parameters in the subsequent eyes, overcorrection decreased to 11%. Two thirds of the eyes that experienced overcorrection were keratoconic, suggesting the ectatic eyes may be at increased risk for overcorrection (Kumar et al, 2010). To date, there is one case report in the literature in which there was evidence of a largethickness perforation immediately after femtosecond-assisted astigmatic keratotomy (Vaddavalli et al, 2011).…”

Long-term Outcomes After Mechanized Arcuate Keratotomy for the Correction of Astigmatism After Keratoplasty

“…1 The recent introduction and development of femtosecond laser-assisted keratotomy could potentially combine a wide range of corrections with the accuracy and safety of laser treatment. 2,3 Assessing the long-term visual and keratometric outcomes of mechanized keratotomy may provide interesting data to predict the evolution of corneal incisions over time. The purpose of this study was to assess the long-term outcome and stability of mechanized arcuate keratotomy in patients after keratoplasty.…”

“…2,3 There is still concern about potential late complications, such as astigmatic regression or corneal ectasia. One major contribution of this study is the comparison of scheduled and actual incision depths measured with high-resolution optical coherence tomography over time, which revealed a substantial lack of reliability of the automated technique.…”