Posters

A new combined technique of deep intrastromal arcuate keratotomy with in situ keratomileusis (DIAKIK) for the treatment of high naturally occurring astigmatism

Poster Details

First Author: L. Laroche FRANCE

Co Author(s):    O. Levy   P. Loriaut   N. Bouheraoua   C. Temstet   L. Jouve   V. Borderie     

Abstract Details

Purpose:

To evaluate a new technique of Deep Intrastromal Arcuate Keratotomy with In Situ Keratomileusis (DIAKIK) followed by excimer photoablation to correct high naturally occurring astigmatism, beyond the range of regular Laser in situ keratomileusis (LASIK).

Setting:

Prospective interventional uncontrolled case series at Quinze-Vingts National Ophthalmology Hospital, Paris, France. Methods:

Methods:

Patients underwent a two-steps procedure. The first step was deep intrastromal arcuate keratotomy with lamellar keratotomy (corneal flap) at 100 µm depth by femtosecond laser. The corneal flap was manually lifted and deep intrastromal incisions were rinsed. At least one month later, after refraction and topography stabilization, the second step consisted in reopening the flap and using an excimer laser to correct residual ametropia. The main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and mean cylinder after each step.

Results:

The study included 15 eyes of 8 patients (6 women and 2 men). The mean cylinder reduced from 4.37 +/- 1.21 (SD) diopters (D) preoperatively to 0.95 +/- 0.46 D postoperatively. The mean UDVA improved from 0.83 +/- 0.56 logMAR (20/125) preoperatively to 0.07 +/- 0.06 logMAR (20/20) postoperatively. The mean correction index was 1.06 +/- 0.17 and the mean flattening index was 1.04 +/- 0.17 for the two-steps procedure. No complications were observed.

Conclusions:

DIAKIK procedure followed by excimer photoablation is a safe and effective technique for management of high naturally occurring astigmatism. Therefore it allows correcting high ranges of ametropia, otherwise beyond the range of LASIK. Larger series of patients and longer follow-up should confirm these results and determine long-term benefits and safety.

Financial Disclosure:

NONE