Clinical utility of femtosecond laser-assisted astigmatic keratotomy after cataract surgery

Purpose To examine the clinical utility of femtosecond laser-assisted astigmatic keratotomy (FSL-AK) for eyes after cataract surgery. Methods Eight eyes of 6 patients with an intraocular lens and corneal astigmatism of 2.0 diopters (D) or more underwent FSL-AK. The mean preoperative manifest cylindrical refraction was 2.88 +/- 0.64 D and the mean corneal astigmatism was 2.84 +/- 0.83 D. Paired symmetrical arcuate incisions were created with the same settings, except for the incision depth. Uncorrected distance visual acuity (UDVA), manifest cylindrical power, and surgically induced astigmatism (SIA) were measured at 1 day, 1 week, and 1 month postoperatively. Fourier analysis of corneal topography and incision depths measured with anteriorsegment optical coherence tomography were evaluated 1 month postoperatively. Results In all eyes, the UDVA improved at 1 week and 1 month postoperatively, and the manifest cylinder also decreased postoperatively, while the SIA showed overcorrections in 6 eyes. Fourier analysis showed decreases in spherical and regular astigmatic components and increases in higher-order irregularity. The mean incision depth was measured as 60 mu m deeper than the intended depth. Conclusion The FSL-AK effectively reduced corneal astigmatism and improved the UDVA, although it was demonstrated that the deeper incisions led to overcorrection.