Outcomes of Femtosecond Laser Arcuate Incisions in the Treatment of Low Corneal Astigmatism
Received 28 May 2020
Accepted for publication 17 July 2020
Published 7 August 2020 Volume 2020:14 Pages 2229—2236
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Gary Wortz,1 Preeya K Gupta,2 Philip Goernert,3 Caleb Hartley,1 Brayden Wortz,2 Jin Chiu,1 Nikita Jaber1
1Commonwealth Eye Surgery, Lexington, KY 40504, USA; 2Duke Eye Center, Durham, NC 27704, USA; 3Department of Psychology, Brandon University, Brandon, MB R7A 6A9, Canada
Correspondence: Gary Wortz
Commonwealth Eye Surgery, 2353 Alexandria Drive #350, Lexington, KY 40504, USA
Tel +1 859 224-2655
Fax +1 859 223-7147
Purpose: To evaluate real-world outcomes of astigmatism management with femtosecond laser arcuate incisions in patients with low corneal astigmatism (< 1.0 D) using a novel formula for arcuate incision calculation compared to outcomes after conventional cataract surgery without surgical management of astigmatism.
Patients and Methods: The Wörtz-Gupta™ Formula (available at www.lricalc.com) was used to calculate femtosecond laser arcuate parameters for 224 patients with < 1 D of corneal astigmatism who underwent cataract surgery; lens power was determined with the Barrett Universal II formula. Uncorrected distance visual acuity (UCDVA) and refractive astigmatism measurements were obtained, with an average follow-up of 4 weeks.
Results: The average preoperative cylinder was similar (0.61 D in the femtosecond group [n=124] and 0.57 D in the conventional group [n=100] (P> 0.05)). More patients had ≤ 0.5 D of postoperative corneal astigmatism in the femtosecond group (n=110/124, 89%) than in the conventional group (n=71/100, 71%), respectively (P=0.001). The mean absolute postoperative refractive astigmatism was higher in the conventional surgery group than in the femtosecond group (0.43 ± 0.4 D vs 0.26 ± 0.28 D); these differences were statistically significant (P< 0.001). The percentage of patients with UCDVA of 20/20 or better vision was higher in the femtosecond group (62%) than the conventional group (48%) (P=0.025).
Conclusion: Using the femtosecond laser for arcuate incisions in combination with a novel nomogram can provide excellent anatomic and refractive outcomes in patients with lower levels of preoperative astigmatism at the time of cataract surgery.
Keywords: femtosecond laser-assisted cataract surgery, arcuate incision, visual acuity, refractive outcome, corneal astigmatism
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]