August 28, 2018
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Femtosecond arcuate keratotomy advantageous in astigmatic correction

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Compared to manual limbal relaxing incisions performed in conventional phacoemulsification cataract surgery, nonpenetrating femtosecond laser arcuate keratotomy performed during femtosecond laser-assisted cataract surgery can achieve an astigmatic correction of greater magnitude, according to a study.

Perspective from John P. Berdahl, MD

The randomized controlled trial compared the results of 400 patients who underwent cataract surgery, of which 200 were operated with conventional phacoemulsification and 200 with femtosecond laser-assisted cataract surgery. Fifty-one eyes of 51 patients in the phacoemulsification group underwent LRI, and 53 in the femtosecond laser-assisted group underwent femtosecond arcuate keratotomy. Seventeen patients from the two subgroups were excluded from further analysis because of visual comorbidities. All postoperative results were recorded at 4 weeks’ follow-up.

Eight LRI patients (20%) and 18 femtosecond arcuate keratotomy patients (44%) attained a postoperative cylinder of less than 0.50 D, and 18 patients (44%) vs. 32 patients (74%) attained less than 1.00 D of cylinder. The mean corneal astigmatism was reduced from 1.38 D to 0.89 D in the femtosecond arcuate keratotomy group and from 1.50 D to 1.17 D in the LRI group.

“[B]oth manual LRIs and femtosecond laser intrastromal arcuate keratotomies were safe and easy to perform, with both achieving a meaningful reduction in corneal astigmatism. However, the laser group achieved a correction of greater magnitude than the LRI cohort 4 weeks after surgery,” the authors wrote. – by Michela Cimberle

 

Disclosure: Roberts reports no relevant financial disclosures. Please see the study for the other authors’ financial disclosures.