Vector Analysis of Corneal Astigmatism After Combined Femtosecond-Assisted Phacoemulsification and Arcuate Keratotomy

Chan, Tommy C Y; Cheng, George P.M.; Wang, Zheng; Tham, Clement C.; Woo, Victor C.P.; Jhanji, Vishal

doi:10.1016/j.ajo.2015.05.004

Cited by 67 publications

(59 citation statements)

References 25 publications

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“…This analysis revealed a trend to undercorrection, with a mean DV value of 0.57 ± 0.34 D 3 months postoperatively. This trend has been also reported in previous studies [13] [16]. In our series, this trend to undercorrection was maintained during the 12-month follow-up.…”

Section: A Kaczmarek Et Al Open Journal Of Ophthalmologysupporting

confidence: 92%

Non-Penetrating Femtosecond Laser Intrastromal Astigmatic Keratotomy Performed during Laser-Assisted Cataract Surgery: Results on Keratometric Astigmatism

Kaczmarek¹,

Brockmann²,

Laube³

2017

OJOph

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Purpose: To investigate the efficacy of non-penetrating femtosecond laser intrastromal astigmatic keratotomy (ISAK) in terms of topographic and refractive changes. Methods: Retrospective study including 42 eyes (35 patients) with a corneal astigmatism between 0.5 and 1.5 D. All eyes underwent femtosecond laser-assisted cataract surgery with ISAK for astigmatism management using the Catalys laser system (Johnson & Johnson Vision). Visual acuity, refraction, as well as corneal topographic and corneal endothelial cell density (ECD) changes were evaluated during a 12-month follow-up. Astigmatic changes were analyzed using the Alpins vector method. Results: A significant reduction in manifest cylinder was observed at 1 month postoperatively (p = 0.03), with no significant changes afterwards (p = 0.90). A total of 38.1%, 52.4% and 59.2% of eyes had a manifest cylinder of 0.50 D or lower preoperatively and at 1 and 12 months after surgery, respectively. A significant reduction was found in topographic astigmatism at 1 month postoperatively (p < 0.01), with an additionally small but statistically significant reduction afterwards (p < 0.01). No significant changes in postoperative uncorrected (p = 0.97) and corrected visual acuities (p = 0.40) were observed during the follow-up. There was a trend to undercorrection of corneal astigmatism that decreased significantly over time. This led to some variability in changes of refractive astigmatism. A small but significant reduction in ECD was observed at 1 month postoperatively (p < 0.01), with no significant changes afterwards. Conclusions: Femtosecond laser assisted ISAK is an effective and safe option to reduce corneal astigmatism during cataract surgery and consequently refractive astigmatism.

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Section: A Kaczmarek Et Al Open Journal Of Ophthalmologysupporting

confidence: 92%

Non-Penetrating Femtosecond Laser Intrastromal Astigmatic Keratotomy Performed during Laser-Assisted Cataract Surgery: Results on Keratometric Astigmatism

Kaczmarek¹,

Brockmann²,

Laube³

2017

OJOph

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“…With the advent of femtosecond laser-assisted cataract surgery, intrastromal astigmatic keratotomy is gaining popularity. 15,16 In terms of analyzing the astigmatic change, the inclusion of corneal incisions introduces another slightly different set of analyses. Given that the change is on the cornea, graphs H and I should ideally be included but analyzed based on the change in corneal astigmatism.…”

Section: Corneal Incisions For Astigmatic Correction At the Time Of Lmentioning

confidence: 99%

Standard for Reporting Refractive Outcomes of Intraocular Lens–Based Refractive Surgery

Reinstein¹,

Archer²,

Srinivasan³

et al. 2017

J Refract Surg

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“…8–10 To our knowledge, this is the first study to investigate the achieved IS incision depth postoperatively using anterior segment OCT and compare the achieved IS incision location postoperatively to the intended location.…”

Section: Discussionmentioning

confidence: 99%

“…The effectiveness of femtosecond-assisted penetrating arcuate keratotomy and IS astigmatic keratotomy combined with cataract surgery have been previously reported. 8–10 …”

mentioning

confidence: 99%

Evaluation of Femtosecond Laser Intrastromal Incision Location Using Optical Coherence Tomography

et al. 2017

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Purpose Using optical coherence tomography (OCT) to evaluate the femtosecond laser intrastromal (IS) incisions made during cataract surgery to reduce corneal astigmatism. Design Retrospective case series. Subjects 77 eyes of 77 patients were included. Methods Paired IS incisions were created using the Catalys femtosecond laser (Abbott Medical Optics, Inc.). The planned IS incision parameters were 20% uncut anterior, 20% uncut posterior, midpoint depth of 50%, and 90° side cut angle. OCT scans were obtained three weeks or more postoperatively to assess these four parameters, and actual values were compared to intended values. Main Outcome Measures Percentages of uncut anterior and posterior tissue, midpoint depth, and degrees of side cut angle. Results The mean values were 17.2% ± 5.8% (range 7.2% to 36.9%) for uncut anterior, 32.5% ± 8.8% (range 6.0% to 57.9%) for uncut posterior, and 42.3% ± 6.6% (range 25.5% to 65.4%) for midpoint depth, which were all significantly different from the planned parameters (all P<0.05). The mean side cut angle was 88.5° ± 5.6° (range 71° to 114°) and was significantly different from the planned side cut angle of 90° (P<0.05). In 50 eyes that had paired IS incisions scanned by the OCT, there was no correlation between the paired incisions for midpoint depth and side cut angle (correlation coefficient r = −0.063 and −0.067, respectively, P>0.05). Conclusions The IS incision midpoint depth was significantly more anterior than the planned depth of 50%. The location of paired IS incisions in each eye were not correlated. Further improvements are needed to ensure the precise location of the IS incisions made with this device.

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Vector Analysis of Corneal Astigmatism After Combined Femtosecond-Assisted Phacoemulsification and Arcuate Keratotomy

Cited by 67 publications

References 25 publications

Non-Penetrating Femtosecond Laser Intrastromal Astigmatic Keratotomy Performed during Laser-Assisted Cataract Surgery: Results on Keratometric Astigmatism

Non-Penetrating Femtosecond Laser Intrastromal Astigmatic Keratotomy Performed during Laser-Assisted Cataract Surgery: Results on Keratometric Astigmatism

Standard for Reporting Refractive Outcomes of Intraocular Lens–Based Refractive Surgery

Evaluation of Femtosecond Laser Intrastromal Incision Location Using Optical Coherence Tomography

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