Femtosecond-assisted astigmatic keratotomy for post-keratoplasty irregular astigmatism
Received 23 March 2008; received in revised form 24 July 2008; accepted 6 August 2008.
We describe the technique of femtosecond-assisted astigmatic keratotomy (AK) in a post-keratoplasty patient with irregular, nonorthogonal astigmatism. Using the keratoplasty software, an anterior arcuate side cut (400 μm thick, 6.5 mm diameter) was created using the femtosecond laser in a 68-year-old woman with irregular astigmatism 28 years after penetrating keratoplasty for keratoconus. No intraoperative or postoperative adverse events were seen during the follow-up period. Six months after the procedure, the uncorrected visual acuity improved from 20/60 to 20/50 and the best spectacle-corrected visual acuity, from 20/50 to 20/32. The mean manifest astigmatic correction decreased from 4.00 diopters (D) to 0.50 D; corneal topography showed a significant improvement in irregular astigmatism. The technique of femtosecond-assisted AK is simple and efficient for managing irregular and nonorthogonal astigmatism in post-keratoplasty patients and may overcome the limitations of earlier techniques.
From the Corneal and External Diseases Department (Kymionis, Yoo, Ide, Culbertson), Bascom Palmer Eye Institute, Miami, Florida, USA; the Department of Ophthalmology (Kymionis), Vardinoyannion Eye Institute of Crete, Crete, Greece
Corresponding author: George D. Kymionis, MD, PhD, Institute of Vision and Optics, University of Crete, Medical School, Department of Ophthalmology, 71110 Heraklion, Crete, Greece.
Doctors Yoo and Culbertson received travel grants and speakers' honoraria from IntraLase Corp. No other author has a financial or proprietary interest in any material or method mentioned.
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