Femtosecond laser arcuate incisions for correction of astigmatism in patients undergoing cataract surgery: transepithelial vs intrastromal

Session Details

Session Title: Femtolaser-Assisted Cataract Surgery (FLACS)

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

Paper Time: 08:30

Venue: Free Paper Forum: Podium 4

First Author: : D.Lopes PORTUGAL

Co Author(s): :    T. Loureiro   R. Carreira   S. Barros   J. Cardoso   I. Machado   N. Campos              

Abstract Details

Purpose:

The purpose of our study was to compare the results of intrastromal arcuate incisions (AIs) and transepithelial AIs for the treatment of astigmatism during femtosecond laser-assisted cataract surgery.

Setting:

Garcia de Orta Hospital.

Methods:

This is a prospective study conducted between July and September of 2018. It comprised patients having laser cataract surgery and presenting corneal astigmatism between 0.70 diopters (D) and 2.00 D. The AIs were performed by Catalys® femtosecond laser system. We used Julian Stevens´s nomogram to calculate intrastromal AIs and an adaptation of manual Donnenfeld limbal relaxing incision nomogram to calculate transepithelial AIs that applies a correction of 70% for with-the-rule, 80% for oblique and 100% for against-the-rule astigmatism. Corneal astigmatism was measured preoperatively and 2-3 months after surgery.

Results:

This study included 32 eyes of 32 patients with a mean age of 69.4 ± 8.9 years. Average preoperative astigmatism with IOL Master® 1.25 ± 0.41 D and with Pentacam® 1.13 ± 0.64 D. Both intrastromal and transepithelial AIs allowed a significant reduction in preoperative astigmatism (p <0.05). A high percentage of patients achieved a residual refractive astigmatism of 0.5 D or less at 3 months (75% transepithelial vs. 87% intrastromal). Correction index (CI) was higher in transepithelial AIs (0.83 vs 0.62) but associated with higher percentage of over-correction. No intra- or postoperative complications related to AIs were recorded.

Conclusions:

Both intrastromal and transepithelial AIs showed potential for management of mild to moderate astigmatism. Although transepithelial AIs presented a higher CI, the intrastromal AIs results are more predictable. These results point to a promising future in astigmatism correction with femtosecond laser AIs performed during cataract surgery.

Financial Disclosure:

None