Femtosecond laser arcuate incisions reduce refractive astigmatism
LAS VEGAS — Arcuate incisions made with a femtosecond laser reduce postoperative refractive astigmatism during cataract surgery, according to a study presented here.
“I was very excited for this project in particular,” Clayton G. Blehm, MD, said at the American Society of Cataract and Refractive Surgery meeting. “Technology fascinates me, but combine that with health care, and sometimes tech is not always beneficial. That’s been part of the question we’ve had for the last 10 years, which is, ‘How much better is femto?’”

Blehm conducted a comparative, prospective, randomized contralateral study in 76 eyes of 38 patients. Visual outcomes for incisions made with the LenSx femtosecond laser (Alcon) using the Woodcock nomogram at 90% thickness were compared with those manually made with a fixed keratome diamond knife using the Donnenfeld nomogram. Subjects were assessed at 1 day, 1 month and 3 months after the procedure.
Corneal astigmatism, refractive astigmatism, uncorrected distance visual acuity and manifest refraction were not significantly different between the two groups. Refractive astigmatism was significantly lower at 3 months than at 1 month in both patient groups.
Two nonserious adverse events, which Blehm called the “humbling factor” for any surgeon, occurred in the manual incision group and were addressed without incident.
In addition, the femtosecond laser may have the advantage of earlier stability of refractive and corneal astigmatism.