Using Total Corneal Astigmatism With Femtosecond Laser Cataract Surgery and Arcuate Keratotomy(ies) to Treat Low Amounts of Astigmatism

Purpose:The aim of this study was to evaluate outcomes using total corneal astigmatism (TCA) to calculate arcuate keratotomy(ies) (AK) parameters performed with femtosecond laser-assisted cataract surgery to reduce low corneal astigmatism. Methods:Patients who had femtosecond laser-assisted cataract surgery and AK with 0.50 diopter (D) to 1.30 D of TCA were included. Exclusion criteria were intraoperative complications, preexisting corneal surgery, and comorbidities that might adversely affect outcomes. Corneal tomography (Galilei G4, Zeimer Ophthalmic Systems AG) was performed preoperatively and 1 month postoperatively. TCA was input into the Donnenfeld limbal relaxing incisions nomogram to calculate the AK parameters. Preoperative and postoperative tomographic and subjective refractive measurements were compared. The Alpins method for vector analysis evaluated results. Results:Eighty-two eyes of 82 patients were included. Mean preoperative TCA was significantly reduced from 0.80 +/- 0.19 D to 0.51 D +/- 0.26 D (P < 0.001). Preoperative posterior corneal astigmatism, -0.28 +/- 0.13 D, was unchanged, postoperative posterior corneal astigmatism, -0.28 +/- 0.14 D (P = 0.653). Target-induced astigmatism arithmetic mean (0.82 +/- 0.21 D) was greater than that of the surgically induced astigmatism (0.70 +/- 0.40 D), resulting in an arithmetic mean difference vector of 0.51 +/- 0.27 D with a summated mean at 0.16 D at 20 degrees. The correction index was 0.87, indicating undercorrection. Angle of error arithmetic mean, -1.27 +/- 23.27 degrees, indicated good alignment. Conclusions:Inputting TCA for calculation of femtosecond laser AK parameters can reduce low amounts of preoperative corneal astigmatism, thereby improving uncorrected vision.