Reduction of astigmatism by arcuate incisions using the femtosecond laser after corneal transplantation

Aim: We examined the effectiveness of arcuate incisions by femtosecond laser treatment for high astigmatism in corneal transplants. Background: High astigmatism is a well known complication after corneal transplantation and is difficult to treat. At present, there are many surgical procedures for the correction of high astigmatism after PKP in case of an unsuccessful contact lens therapy. Patients and Methods: Ten patients with a high postoperative astigmatism underwent arcuate keratotomy with the Femtec(R) laser. We performed two arcuate incisions on each transplant. With the femtosecond laser technology it is possible to perform precise incisions where the depth and length of the arcus can be programmed. Results: The best corrected visual acuity was improved in eight out of ten patients. The visual acuity of two patients did not change. The average corneal astigmatism was reduced by three dioptres. The average refractive astigmatism was reduced by four dioptres. Conclusion: Arcuate incisions with the femtosecond laser on patients with high astigmatism subsequwent to corneal transplantation are an effective and safe treatment.