One-Year Results of Arcuate Keratotomy in Patients With Low to Moderate Corneal Astigmatism Using a Low-Pulse-Energy Femtosecond Laser

PURPOSE: To investigate corneal astigmatism (CA) reduction and corneal optical quality after surface-penetrating femtosecond laser arcuate keratotomies (Femto AK) considering anterior (CA(ant)) and posterior corneal curvature (CA(post)), total corneal refractive power astigmatism (CA(tot)), and corneal higher-order aberrations (HOAs) through 1 year.DESIGN: Prospective interventional case series.METHODS: SETTING: Department of Ophthalmology, Medical University of Vienna. PATIENT POPULATION: Forty-three eyes of 43 patients with age-related cataract and CAtot between 1 and 3 diopters (D).INTERVENTION: Paired keratotomies were created with a low-energy femtosecond laser (LDV Z8; Ziemer Ophthalmic Systems, Port, Switzerland) and combined with an astigmatic neutral manual posterior-limbal cataract incision. CAand HOAs measurements were obtained preoperatively and after 1 month, 3 months, and 1 year.MAIN OUTCOME MEASURE: Change of CA and HOAs after low-energy Femto AK through 1 year.RESULTS: Mean preoperative CA(ant) and CA(tot) (1.62 +/- 0.49 D and 1.58 +/- 0.44 D) were significantly reduced, to 0.66 +/- 0.38 and 0.50 +/- 0.30 D (P<.001) 1 year after surgery, respectively. CApost showed no significant change, from 0.31 +/- 0.19 D preoperatively to 0.31 +/- 0.13 D (P[.732) at the 1-year follow-up period. Astigmatism as calculated by vector astigmatism analysis stayed stable at 1 month, 3 months, and 1 year. Corneal wavefront HOAs significantly improved at 1 month, 3 months, and 1 year.CONCLUSIONS: Paired surface-penetrating keratotomies created by a low-energy femtosecond laser showed efficient and stable CA reduction within 1 year after surgery. The optical quality of the cornea was preserved with lower HOAs than preoperatively. (C) 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).)