Refractive outcomes after topographically oriented arcuate keratotomy during cataract surgery using the VERION system

Session Details

Session Title: Femtolaser-Assisted Cataract Surgery (FLACS)

Session Date/Time: Monday 16/09/2019 | 08:30-10:30

Paper Time: 08:42

Venue: Free Paper Forum: Podium 4

First Author: : S.Demyanchenko RUSSIA

Co Author(s): :    M. Okuneva   A. Tereschenko   I. Trifanenkova   M. Vlasov   M. Timofeev   E. Vishnyakova              

Abstract Details

Purpose:

To compare the outcomes of manual limbal relaxing incisions (LRIs) with those of non-penetrating femtosecond laser arcuate keratotomies during the phacoemulsification of cataracts (PhEC) using the VERION system.

Setting:

Kaluga branch of FGAU «NMIC «MNTK «Eye Microsurgery» named after acad. S.N. Fedorov»

Methods:

Depending the preference, patients with cataract and concomitant corneal astigmatism greater than 1.25 diopter had femtosecond laser-assisted PhEC or PhEC with manual LRIs. The parameters – the location of the main incision, paracentesis, arcuate cuts – were calculated by the VERION system in both groups. To exclude cyclotorsion and localization errors in both groups, preoperative marking of arcuate incisions was applied using intraoperative navigation system VERION. 1, 3 and 6 months after treatment, the uncorrected visual acuity, corneal and refractive astigmatism were compared between the groups. Correlation between targed-induced astigmatism (TIA) and surgically induced astigmatism (SIA) were also compared between the groups.

Results:

In femtosecond group 1 (26 eyes) uncorrected visual acuity were 0,61±0,14. In manual LRIs group 2 (24 eyes) – 0,48±0,18. Complete corneal astigmatism correction in group 1 was achieved in 73%, SIA to 0.75±0.11 D and 42% SIA to 1.15±0.25 D in group 2 respectively. The reduction of the initial astigmatism in all groups was statistically significant. The correlation between TIA and SIA was greater in group 1. The topographical location of the corneal arcuate incisions corresponded exactly to the planned one. Stabilisation of keratometric parameters in both groups occurred within 3-6 months.

Conclusions:

Thanks to the VERION system, it became possible to carry out a high-precision calculation of the parameters of the arcuate incisions. Topographical orientation with subsequent intraoperative navigation allows the surgeon to facilitate continuous precise control over the positioning of the axis of the astigmatic component, which contributes to the achievement of the planned compensation of the initial corneal astigmatism and the maximum possible visual acuity in the early postoperative period. Topographically oriented variant system of arcuate keratotomy allows to achieve a clear localisation of the planned incisions. The femtosecond arcuate keratotomy patients showed less postoperative cylinder than manual LRIs patients.

Financial Disclosure:

None