Intrastromal femtosecond arcuate incisions with the Catalys system for correction of corneal astigmatism during femtosecond laser-assisted cataract surgery (FLACS)

Session Details

Session Title: Presented Poster Session: FLACS

Venue: Poster Village: Pod 1

First Author: : D.Teenan UK

Co Author(s): :    S. Hannan   D. Hannan   A. Laux                 

Abstract Details

Purpose:

Toric IOLs have their indication in cataract surgery for pre-existing corneal astigmatism of 1.50 dioptres or more, but lower astigmatism may also limit the expectation of a perfect visual performance if untreated during surgery especially in premium lenses. The goal of the present study was to evaluate the efficacy of 2 paired intrastromal arcuate fs-laser cuts during FLACS in terms of reduction of corneal astigmatism and visual outcome.

Setting:

Optical Express, Glasgow, UK

Methods:

Based on keratometric measurement with the IOL Master Paired symmetric intrastromal fs-laser cuts have been performed using the Catalys laser system and the arc length of the cuts was adapted to corneal astigmatism according to the Julian Stevens nomogram. Keratometry, subjective refraction, uncorrected and corrected visual acuity were evaluated preoperatively and 1 and 3 months after the surgery.

Results:

Thirty six eyes with a pre-existing median corneal astigmatism of 0.87D were treated with intrastromal femtosecond arcuate incisions and FLACS. Keratometric astigmatism reduced from 0.92±0.28D to 0.41±0.18D and 0.32±0.18D after 1 month and 3 month respectively. Spherical equivalent /refractive cylinder changed from 1.97±2.96/-0.51±0.46D preoperatively to -0.28±0.58/-0.32±0.20D after 1 month and -0.18±0.67/-0.27±0.15D after 3 months.. Surgical induced astigmatism at 1 month/3 month (0.56±0.43/0.52±0.44D) correlated statistically significantly with the target induced astigmatism (R²=0.51/0.64).

Conclusions:

In contrast to manually performed arcuate keratotomies with the diamond knife Intrastromal femtosecond arcuate incisions seems to be a safe and robust option for correction of pre-existing low to moderate corneal astigmatism in cataract surgery. Especially for premium IOLs where corneal astigmatism is well known to deteriorate visual performance significantly these cuts might be a proper alternative to excimer laser corrections. Nomograms have to be adjusted to avoid under-correction of the effect in the future.

Financial Disclosure:

None