Posters

Femtosecond laser-assisted intrastromal astigmatic keratotomy in penetrating keratoplasty: one-year efficacy and safety data

Poster Details

First Author: T. Yeung AUSTRALIA

Co Author(s):    R. Conlon   J. Teichman   S. Ziai   G. Mintsioulis   B. Jackson   K. Baig     

Abstract Details

Purpose:

To report the one-year outcomes of the correction of astigmatism with femtosecond laser-assisted intrastromal astigmatic keratotomy (FISAK) in patients with previous penetrating keratoplasty (PKP)

Setting:

The University of Ottawa Eye Institute, Ottawa, Ontario, Canada

Methods:

A prospective, non-randomized, interventional case series. A femtosecond laser (IntraLase™; AMO) was utilised to create a pair of intrastromal arcuate incisions in 10 eyes of 10 post-penetrating keratoplasty patients with high corneal astigmatism (≥ +4.00 D). Multiple postoperative visits were scheduled during the one-year follow up period. The primary outcomes of the study were postoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA). The secondary outcomes were the reductions of refractive and topographic cylinder. Both intra-operative and postoperative complications were also documented. All patients completed the one-year follow-up.

Results:

At the one-year follow up, a statistically significant decrease in mean refractive sphere was observed (-5.88 D +/- 3.00 D to -4.50 D +/- 3.44 D; P=0.03). Both the preoperative mean refractive cylinder (5.13 D +/- 1.27 D) and mean topographic cylinder (5.90 D +/- 2.37 D) were significantly (P=0.005) reduced postoperatively (2.63 D + 1.90 D and 4.88 D + 2.45 D, respectively). There was no significant change in mean topographic keratometry in the first 6 months after FISAK, but a statistically significant increase was detected at one-year follow-up (46.86 D + 2.09 D to 47.36 D + 1.96 D; P=0.02). There were no statistically significant changes in other topographic measurements. No serious adverse events were reported.

Conclusions:

FISAK is a precise, effective, and safe technique in the treatment of high corneal astigmatism in post-penetrating keratoplasty patients. Significant improvements in mean refractive sphere, mean refractive cylinder and mean topographic cylinder were observed one year post FISAK. A late increase in mean topographic keratometry was noted following FISAK and further study may be required to determine its significance. Femtosecond laser-assisted intrastromal arcuate incisions provide a rapid postoperative recovery and an excellent safety profile.

Financial Disclosure:

NONE