Femtosecond Laser-Assisted Surgical Management of Postkeratoplasty Astigmatism: Indications and Results
Post-keratoplasty astigmatism is one of the leading causes of low vision after corneal transplantation. Purpose. To study the effectiveness of surgical management of high post-keratoplasty astigmatism after corneal transplantation for keratoconus. Materials and methods. The study included 24 patients (24 eyes) with post-keratoplasty astigmatism. Group 1 included 15 patients with regular astigmatism who underwent femtosecond laser-assisted arcuate keratotomy (FLAK); the 2nd consisted of 9 patients, 6 of whom had irregular astigmatism. In group 2, femtosecond laser-assisted circular wedge resection of the cornea (FCWR) was performed. Results. In patients of both groups, a significant improvement in keratotopography indices was obtained, as well as an improvement in UCVA and BCVA after surgery. In group 1, initial BCVA was 0.2 (0.10-0.3), final BCVA was 0.6 (0.5-0.7) (T=0, Z=3.408, p<0.001). In group 2, initial BCVA was 0.1 (0.09-0.2), final BCVA - 0.6 (0.55-0.7) (T=0, Z=2.521, p=0.012). Conclusions. FLAK in patients with regular high post-keratoplasty astigmatism helps reduce the keratometric cylinder by 61%, significantly increase both UCVA and BCVA. FCWR is effective for irregular astigmatism and may be an alternative to corneal retransplantation.