To assess the long-term stability of astigmatism correction made with femtosecond laser-created arcuate incisions, Denise Visco, MD, MBA, ABO, Medical Director at Laser Eyes of York, in York, Pennsylvania, reviewed the patient records of 20 eyes of 20 patients with follow-up of 24 to 36 months. All eyes had received laser-created beveled arcuate incisions. A third-party statistician evaluated the data. This included a comparison of keratometric astigmatism along the original steep and orthogonal meridians; comparison of the percentage of cases with up to 0.25 D, 0.50 D, and 1.00 D of intended astigmatic correction; comparison of vector analysis and surgically induced astigmatism, difference in vector, correction index, angle of error and changes in UCVA at varying time intervals up to 36 months.

The findings, presented on an electronic poster, showed that preoperative astigmatism (0.62±0.37 D) reduced significantly at postoperative 4 to 6 weeks (0.32±0.27 D) and was maintained up to 24 to 36 months. More than 90% of the eyes achieved a surgically induced astigmatism within 0.5 D of the target-induced astigmatism.

Mean uncorrected distance visual acuity (UDVA) was maintained from postoperative 4 to 6 weeks (0.09±0.11 logMAR) to 24-36 months (0.08±0.09 logMAR), with 95.5 % of the eyes achieving postoperative UDVA of 20/30 or better.

The study highlights the long-term stability of femtosecond laser-created beveled arcuate incisions in managing low-to-moderate astigmatism, with results maintained through 36 months, the poster concluded. According to Dr. Visco, ophthalmologists should recognize that this technique offers a precise and durable option for correcting lower levels of astigmatism, particularly when toric IOLs may not be available or appropriate.

She said that the beveled design of the incision is significant in promoting corneal biomechanical stability, reducing the risk of regression or wound gaping over time.

“This study was important to validate the performance of a novel, dual-pulse femtosecond laser (LENSAR) and to provide rare long-term outcome data on arcuate keratotomies. These findings support the role of laser arcuate incisions as a valuable tool in refractive cataract surgery, especially for fine-tuning outcomes in patients not requiring higher-powered toric IOLs” Dr. Visco concluded.

Source: Ophthalmology Management