TY - JOUR
T1 - IntraLase-Enabled Astigmatic Keratotomy for Post-Keratoplasty Astigmatism
T2 - On-Axis Vector Analysis
AU - Kumar, Nikhil L.
AU - Kaiserman, Igor
AU - Shehadeh-Mashor, Raneen
AU - Sansanayudh, Wiwan
AU - Ritenour, Rusty
AU - Rootman, David S.
PY - 2010/6
Y1 - 2010/6
N2 - Purpose: To determine the refractive predictability, stability, efficacy, and complication rate of femtosecond laser-enabled astigmatic keratotomy for post-keratoplasty astigmatism. Design: A retrospective case series (pilot study). Participants: Thirty-seven eyes of 34 patients. Methods: All eyes underwent IntraLase-enabled astigmatic keratotomy for high astigmatism (>5 diopters [D]) after penetrating keratoplasty. Main Outcome Measures: Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), manifest refraction, higher-order aberrations, and complications. Results: Mean follow-up was for 7.2 months. Uncorrected visual acuity improved from a mean of 1.08±0.34 logarithm of the minimum angle of resolution preoperatively to a mean of 0.80±0.42 postoperatively (P=0.0016). Best-corrected visual acuity improved from a mean of 0.45±0.27 preoperatively to 0.37±0.27 postoperatively (P=0.018). The defocus equivalent was significantly reduced by more than 1 D (P=0.025). The value of absolute astigmatism was reduced from 7.46±2.70 D preoperatively to 4.77±3.29 D postoperatively (P=0.0001). Higher-order aberrations were significantly increased. The efficacy index was 0.6±0.6. There were no cases of perforation, wound dehiscence, or infectious keratitis. Three eyes (8%) experienced an episode of graft rejection. Overcorrection occurred in 9 eyes (24%). Conclusions: IntraLase-enabled astigmatic keratotomy is an effective treatment for high astigmatism after penetrating keratoplasty with an encouraging refractive predictability. Future studies may help refine the treatment parameters required to achieve reduction of cylinder with greater accuracy. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
AB - Purpose: To determine the refractive predictability, stability, efficacy, and complication rate of femtosecond laser-enabled astigmatic keratotomy for post-keratoplasty astigmatism. Design: A retrospective case series (pilot study). Participants: Thirty-seven eyes of 34 patients. Methods: All eyes underwent IntraLase-enabled astigmatic keratotomy for high astigmatism (>5 diopters [D]) after penetrating keratoplasty. Main Outcome Measures: Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), manifest refraction, higher-order aberrations, and complications. Results: Mean follow-up was for 7.2 months. Uncorrected visual acuity improved from a mean of 1.08±0.34 logarithm of the minimum angle of resolution preoperatively to a mean of 0.80±0.42 postoperatively (P=0.0016). Best-corrected visual acuity improved from a mean of 0.45±0.27 preoperatively to 0.37±0.27 postoperatively (P=0.018). The defocus equivalent was significantly reduced by more than 1 D (P=0.025). The value of absolute astigmatism was reduced from 7.46±2.70 D preoperatively to 4.77±3.29 D postoperatively (P=0.0001). Higher-order aberrations were significantly increased. The efficacy index was 0.6±0.6. There were no cases of perforation, wound dehiscence, or infectious keratitis. Three eyes (8%) experienced an episode of graft rejection. Overcorrection occurred in 9 eyes (24%). Conclusions: IntraLase-enabled astigmatic keratotomy is an effective treatment for high astigmatism after penetrating keratoplasty with an encouraging refractive predictability. Future studies may help refine the treatment parameters required to achieve reduction of cylinder with greater accuracy. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
UR - http://www.scopus.com/inward/record.url?scp=77952890066&partnerID=8YFLogxK
U2 - 10.1016/j.ophtha.2009.10.041
DO - 10.1016/j.ophtha.2009.10.041
M3 - Article
C2 - 20163860
AN - SCOPUS:77952890066
VL - 117
SP - 1228–1235.e1
JO - Ophthalmology
JF - Ophthalmology
SN - 0161-6420
IS - 6
ER -