Long-Term Stability of Femtosecond Astigmatic Keratotomy After Treatment of High Postkeratoplasty Astigmatism

Abstract

Purpose:The purpose of this study was to assess long-term stability and outcomes of femtosecond astigmatic keratotomy (FSAK) after treatment of high postkeratoplasty astigmatism.Methods:This retrospective study included patients who underwent FSAK for high astigmatism (≥4 D) after penetrating keratoplasty or deep anterior lamellar keratoplasty. Main outcome measures were corneal astigmatism, uncorrected visual acuity, and best-corrected visual acuity (BCVA) at 1 month and 1, 5, and 10 years.Results:Overall, 61 eyes of 61 patients (mean age 56 ± 19 years, 54.1% male) were included in this study. Preoperative corneal astigmatism ranged from 4 to 25 D. One month after FSAK, mean corneal astigmatism was significantly reduced from 9.02 ± 3.97 D to 4.86 ± 3.10 D (P < 0.001). Thereafter, corneal astigmatism remained stable at all visits up to 10 years (P < 0.05 for all compared with baseline). After FSAK, there was a significant improvement in logMAR uncorrected visual acuity from 1.21 ± 0.48 to 0.87 ±0.54 (P < 0.001) and logMAR BCVA from 1.03 ± 0.55 to 0.49 ± 0.45 (P < 0.001) which remained stable up to 10 years. A mild reduction in BCVA improvement was seen between 1 month and 1 year.Conclusions:Femtosecond astigmatic keratotomy was effective and stable at reducing very high magnitudes of postkeratoplasty astigmatism over the long term. The procedure also had a stable effect on visual acuity, albeit some reduction in the degree of BCVA improvement was seen over the early postoperative period.

Using Total Corneal Astigmatism With Femtosecond Laser Cataract Surgery and Arcuate Keratotomy(ies) to Treat Low Amounts of Astigmatism

“…15 In addition, in postkeratoplasty eyes, corneal astigmatism was stable for up to 10 years after femtosecond astigmatic keratotomy. 33 However, 1 study noted significant differences between astigmatic measurements taken at 1 month versus 3 months after surgery. 3 In conclusion, our study highlights the importance of using preoperative TCA to calculate the AK parameters which effectively decreased TCA and did not change PCA.…”

“…15 In addition, in postkeratoplasty eyes, corneal astigmatism was stable for up to 10 years after femtosecond astigmatic keratotomy. 33 However, 1 study noted significant differences between astigmatic measurements taken at 1 month versus 3 months after surgery. 3…”