Efficacy and predictability of femto-assisted arcuate keratotomy for the correction of corneal astigmatism during cataract surgery in elderly and middle-aged patients
Aim. To compare the predictability, efficacy, and safety of femtosecond laser-assisted arcuate keratotomy during cataract surgery in elderly and middle-aged persons. Patients and methods. Prospective open study included 111 patients (139 eyes) who underwend femto-assisted cataract surgery and IOL implantation and simultaneous femto-assisted arcuate keratotomy to correct corneal astigmatism. Visual acuity measurements and keratometry were performed preoperatively and 7 days, 1, 3, and 6 months after the surgery and at the last visit. Patients were subdivided into two groups: group 1 included patients with 3-month follow-up, group 2 included patients with 6-month follow-up or more (up to 10 months). Both groups were additionally subdivided into the subgroups by age (less than 60 years and more than 60 years). Results. Preoperative astigmatism was 0.5 D to 2.0 D. Astigmatism reduced more than twice as compared with preoperative values, i. e., by 0.75 D one month after the procedure (maximum) and by 0.55 D (minimum) three months after the procedure. The difference between astigmatism measured 3 months after the surgery and astigmatism measured more than 6 months after the surgery was less than 0.1 D. The difference in residual astigmatism after 6 months was insignificant (p > 0.05). Astigmatism becomes stable 6 months after the surgery. The coefficient of astigmatism decrease was greater in patients older than 60 years as compared with patients younger than 60 years (2.98 vs. 2.3, respectively). No differences between UCVA and BCVA was reported in patients younger than 60 years. In patients older than 60 years, the difference was 0.06 (p < 0.05). Conclusions. Femto-assisted arcuate keratotomy corrects astigmatism up to 2.0 D. Further studies are required to assess whether astigmatism greater than 2.0 D can be corrected.