Evaluation of the effectiveness of combined femtosecond laser-assisted cataract surgery and femtosecond laser astigmatic keratotomy in improving post-operative visual outcomes

Jing Wang, Jiangyue Zhao, Jun Xu, Jinsong Zhang, Jing Wang, Jiangyue Zhao, Jun Xu, Jinsong Zhang

Abstract

Background: To determine postoperative refractive and visual outcomes and astigmatic changes after femtosecond laser astigmatic keratotomy in femtosecond laser-assisted cataract surgery (FLACS).

Methods: This was a prospective interventional case series. Patients with age-related cataract and corneal astigmatism (1.0-3.0D) were treated with FLACS and femtosecond laser astigmatic keratotomy (FSAK). All patients underwent examinations before and 3 months after surgery; visual acuity, subjective and objective refraction, and corneal astigmatism were evaluated and recorded for all patients by using an OPD-Scan III topographer. Vector analysis of astigmatic changes was performed by using the Alpins vector method.

Results: Twenty-five patients were included in the study. Postoperatively, refractive and corneal astigmatism were both reduced significantly (P < 0.05), concurrent with improved uncorrected distance visual acuity and corrected distance visual acuity. The rate of spectacle use was significantly reduced at 3 months postoperatively (P = 0.001). The mean magnitude of the target-induced astigmatism vector (1.40 ± 0.37D) was slightly higher than the mean magnitude of the surgically induced astigmatism vector (1.22 ± 0.46D). The magnitude of error (- 0.18 ± 0.36D), as well as the correction index (0.88 ± 0.29), demonstrated slight undercorrection. The angle of error was 0.85 ± 13.69°, which was close to zero.

Conclusions: Combined femtosecond laser-assisted cataract surgery and astigmatic keratotomy may be an effective approach to manage preoperative astigmatism in cataract surgery, although slight undercorrection may exist during short-term follow-up.

Trial registration: ChiCTR-TRC-14004977.

Keywords: Astigmatism; Effectiveness; Femtosecond laser astigmatic keratotomy; Femtosecond laser-assisted cataract surgery.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Ethical Committee of the Fourth Affiliated Hospital of China Medical University, Shenyang (No.: 2014-036). We confirm that written consent was obtained from all participants.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
An example of the programmed femtosecond laser-assisted astigmatic keratotomy in femtosecond laser assisted cataract surgery
Fig. 2
Fig. 2
The scatter plot of target induced astigmatism vs. surgically induced astigmatism
Fig. 3
Fig. 3
The angle of error was 0.85 ± 13.69°, indicating that the surgically induced astigmatism was counter-clockwise to the target induced astigmatism
Fig. 4
Fig. 4
The distribution of preoperative corneal astigmatism
Fig. 5
Fig. 5
The distribution of postoperative corneal astigmatism

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Source: PubMed

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