<p>Outcomes of Femtosecond Laser Arcuate Incisions in the Treatment of Low Corneal Astigmatism</p>

Abstract

To evaluate real-world outcomes of astigmatism management with femtosecond laser arcuate incisions in patients with low corneal astigmatism (<1.0 D) using a novel formula for arcuate incision calculation compared to outcomes after conventional cataract surgery without surgical management of astigmatism. Patients and Methods: The Wörtz-Gupta™ Formula (available at www.lricalc.com) was used to calculate femtosecond laser arcuate parameters for 224 patients with <1 D of corneal astigmatism who underwent cataract surgery; lens power was determined with the Barrett Universal II formula. Uncorrected distance visual acuity (UCDVA) and refractive astigmatism measurements were obtained, with an average follow-up of 4 weeks. Results: The average preoperative cylinder was similar (0.61 D in the femtosecond group [n=124] and 0.57 D in the conventional group [n=100] (P>0.05)). More patients had ≤0.5 D of postoperative corneal astigmatism in the femtosecond group (n=110/124, 89%) than in the conventional group (n=71/100, 71%), respectively (P=0.001). The mean absolute postoperative refractive astigmatism was higher in the conventional surgery group than in the femtosecond group (0.43 ± 0.4 D vs 0.26 ± 0.28 D); these differences were statistically significant (P<0.001). The percentage of patients with UCDVA of 20/20 or better vision was higher in the femtosecond group (62%) than the conventional group (48%) (P=0.025). Conclusion: Using the femtosecond laser for arcuate incisions in combination with a novel nomogram can provide excellent anatomic and refractive outcomes in patients with lower levels of preoperative astigmatism at the time of cataract surgery.

Femtosecond laser-assisted arcuate keratotomy for the management of corneal astigmatism in patients undergoing cataract surgery: Comparison with conventional cataract surgery

“…However, the overcorrection rates did not significantly differ between the groups ( p = 0.643). In another study, the authors reported that, in patients with a relatively lower degree of corneal astigmatism, FL-AK outcomes were influenced by preoperative corneal astigmatism and uncorrected visual acuity ( 18 ). The authors of that study utilized a novel formula to reduce the corneal incision arc by 20–30%, and the novel formula was more effective in correcting low astigmatism than the pre-existing method.…”

Clinical Outcomes After Femtosecond Laser-Assisted Arcuate Corneal Incisions versus Manual Incisions

“…It is possible that more recent, advanced nomograms/formulas could further improve mean results or reduce outcome variability. 15 , 21 …”

<p>Comparing Visual Acuity, Low Contrast Acuity and Refractive Error After Implantation of a Low Cylinder Power Toric Intraocular Lens or a Non-Toric Intraocular Lens</p>

“…Mean results achieved can be similar to those reported here, but in general there is more variability in the outcomes with corneal incisions relative to toric IOLs, particularly when the incisions are made with a blade. 8 Other studies have found that femtosecond LRIs can provide results similar to a toric IOL, [14][15][16] but several authors have noted that the additional surgical time requirement, incision planning and laser system cost might argue for toric IOL use. A meta-analysis of studies that included LRIs made with both manual and femtosecond laser systems suggests that the likelihood of achieving a residual refractive cylinder of ≤0.50 D is higher with a toric IOL.…”