Abstract

DO.25.03

Correction of post-keratoplasty astigmatism with astigmatic keratotomy using the femtosecond laser (femto-AK)

Daniel Kook1, Anna Sophia Bauch2, Jens Bühren2, Oliver Klaproth2, Victor Derhartunian2, Thomas Kohnen2
1Augenklinik, Ludwig Maximilians-Universität München, München; 2Klinik für Augenheilkunde, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt/Main

Objective
To evaluate a novel technique for the correction of postoperative astigmatism after penetrating keratoplasty with the use of the femtosecond laser creating astigmatic keratotomies (femto-AK).
Methods
In scope of a small retrospective case series, clinical data of 10 eyes of 9 patients with high residual astigmatism after penetrating keratoplasty undergoing femto-AK using a 60-kHz femtosecond laser (IntraLase-AMO, Irvine, California, USA) was analyzed. A new software algorithm was used to create paired arcuate cuts deep into the donor corneal button with cut angles between 20 and 50 degrees. Target values were refraction, uncorrected visual acuity, best corrected visual acuity and topographic data (Orbscan, Bausch & Lomb, Rochester, New York, USA).
Results
All procedures were performed without any major complications. Follow-up ranged between 3 and 22 months. Preoperative mean uncorrected visual acuity (logMAR) was 1.27, best corrected visual acuity 0.55, mean subjective cylinder -3.4 D and mean topometric astigmatism 9.3 D. Postoperative mean uncorrected visual acuity (logMAR) was 1.12, best corrected visual acuity 0.47, mean subjective cylinder -4.1 D and mean topometric astigmatism 6.7 D.
Conclusions
Astigmatic keratotomy using the femtosecond laser seems to be a safe, effective and promising tool for the correction of higher corneal astigmatisms. Due to the biomechanical properties of the cornea and missing experience figures with the novel femto-AK technology, higher numbers of patients are necessary to develop optimal treatment nomograms.

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