Femtosecond laser surgery for the correction of high post-keratoplasty astigmatism: a case series

Session Details

Session Title: Presented Poster Session: Refractive Surgery New Techniques/Instrumentation/Devices I

Venue: Poster Village: Pod 2

First Author: : H.Sitnik BELARUS

Co Author(s): :    A. Haddad   D. Abelski                    

Abstract Details

Purpose:

To study the effectiveness of surgical treatment of post-penetrating keratoplasty high astigmatism with the use of IntraLase 60 kHz femtosecond laser.

Setting:

1. Belarusian Medical Academy of Post-Graduate Education, Minsk, Belarus 2. 10th City Hospital, Minsk, Belarus

Methods:

This study included 26 patients (26 eyes, 14 men, 12 women, mean age 32.6 ± 3.4 y.o.) underwent PKP from 2013 to 2015. High astigmatism from 6 to 23 D was diagnosed after suture removal. ECD was 1840 ± 250 cells/mm2. Final UCVA varied from 0.05 to 0.09. Regular astigmatism revealed in 19 cases, irregular one in 7 cases. 10 patients were administered contact lenses. 8 patients underwent femtosecond laser arcuate keratotomies (AK). In 8 patients femtosecond laser-assisted modified wedge resection (WR) was performed, wich consisted in 2-step resection of corneal stroma in the area of host-transplant junction and suturing.

Results:

10 patients successfully used contact lenses (soft toric contact lenses – 2, hard lenses – 8 eyes), corrected VA varied from 0.5 to 0.7. Operations and post-op period were uneventful in all cases. After AK both mean UCVA and BCVA significantly improved from 0.06 ± 0.012 and 0.15 ± 0.09 pre-op to 0.2 ± 0.08 and 0.6 ± 0.1 post-op. Suture removal after modified WR was performed after 12-18 month post-op. In these cases UCVA was 0.3 ± 0.09, BCVA varied from 0.3 to 0.8. The mean keratometric astigmatism decreased from 8.8 ± 3.1 D to 3.7 ± 1.5 D post-op.

Conclusions:

High astigmatism after penetrating keratoplasty is one of the main cause of patient's unsatisfection after succesful corneal transplantation. AK is effective in cases of high regular postkeratoplasty astigmatism. In this case series modified wedge resection with the use of IntraLase 60 kHz femtosecond laser was safe, allowed to improve both UCVA and BCVA in cases of irregular postkeratoplasty astigmatism, avoid repeated corneal transplantation and provided patient’s satisfaction with results of treatment. Further comparative researches are needed to determine the effectiveness of this operation.

Financial Disclosure:

None