Factors Associated With Improvement in Vision Following Femtosecond Astigmatic Keratotomy in Post-Keratoplasty Keratoconus Patients

Kreimei, Mohammad; Sorkin, Nir; Trinh, Tanya; Santaella, Gisella; Cohen, Eyal; Rootman, David S.

doi:10.1016/j.ajo.2020.06.007

Cited by 8 publications

(19 citation statements)

References 27 publications

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“…Although the short-term efficacy and safety of FSAK in the management of postkeratoplasty astigmatism is well- established in recent literature, 4,5,[10][11][12][13][14] there are no published data on its long-term stability. This study investigated the long-term stability of FSAK in eyes with high postkeratoplasty astigmatism, showing a significant reduction in corneal astigmatism which remained stable throughout the 10year follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Our FSAK technique has been previously described. 4,5,8 In brief, the horizontal and steep axes were marked under the Visx laser (Johnson and Johnson Vision) using the reflection of the circular light on the tear film. The eyelids were prepared with Betadine sponges.…”

Section: Surgical Techniquementioning

confidence: 99%

“…1–3 Femtosecond astigmatic keratotomy (FSAK) enables the formation of precise deep arcuate stromal incisions which are effective in reducing the magnitude of high postkeratoplasty astigmatism. 4,5…”

mentioning

confidence: 99%

“…[1][2][3] Femtosecond astigmatic keratotomy (FSAK) enables the formation of precise deep arcuate stromal incisions which are effective in reducing the magnitude of high postkeratoplasty astigmatism. 4,5 One potential issue associated with deep stromal incisions is their long-term refractive stability. For example, radial keratotomy (RK) stromal incisions which have been used in the past for the correction of myopic refractive errors were associated with significant long-term instability.…”

mentioning

confidence: 99%

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

Kisilevsky

AlShaker

Cohen

et al. 2022

Cornea

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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

Kisilevsky

AlShaker

Cohen

et al. 2022

Cornea

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“…Astigmatic keratotomy with or without compression sutures can decrease postkeratoplasty astigmatism, but poor predictability, corneal perforation, wound dehiscence, and regression remain major concerns. 6,7 Tissue-removing corneal procedures such as photorefractive keratectomy, laser in-situ keratomileusis, and small-incision lenticule extraction are limited by the magnitude of astigmatism that can be corrected, potential flap-related problems, and corneal haze. [8][9][10] Toric intraocular lenses (IOLs) and phakic IOLs (pIOL) can correct high amounts of astigmatism and spherical errors.…”

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confidence: 99%

Toric intraocular lenses for astigmatism correction after keratoplasty in phakic and pseudophakic eyes

Wan

Chang

Jhanji

2022

J Cataract Refract Surg

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Residual astigmatism and anisometropia significantly affect patients' vision and quality of life even in clear grafts after corneal transplant. This study reviewed and summarized the role of toric intraocular lenses (IOLs) in phakic and pseudophakic eyes after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty in correcting residual astigmatism. 342 eyes from 20 studies with iris-clipped toric IOL, ciliary sulcus toric implantable collamer lens, piggyback sulcus toric IOL, or posterior chamber toric IOL implantations for phakic, pseudophakic, or eyes undergoing cataract surgery after keratoplasty were included.Visual, refractive, and predictability outcomes were encouraging. Secondary realignment rate and complications were low. Endothelial cell loss secondary to phakic toric IOLs might be a concern over the long-term, particularly in iris-clipped IOLs in PKP eyes. Toric IOLs represent a viable option in the treatment of residual astigmatism in postkeratoplasty eyes, resulting in improved visual acuity and reduced anisometropia.

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Refractive surgery after deep anterior lamellar keratoplasty: a review of the literature

et al. 2022

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Factors Associated With Improvement in Vision Following Femtosecond Astigmatic Keratotomy in Post-Keratoplasty Keratoconus Patients

Cited by 8 publications

References 27 publications

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

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

Toric intraocular lenses for astigmatism correction after keratoplasty in phakic and pseudophakic eyes

Refractive surgery after deep anterior lamellar keratoplasty: a review of the literature

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