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Cornea and External Disease

Femtosecond Arcuate Keratotomy and Limbal Relaxing Incisions Compared

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Patients who underwent femtosecond arcuate keratotomy after cataract surgery achieved a higher correction index and a smaller difference vector than those who received limbal relaxing incisions (LRIs), according to a randomized case-controlled trial involving 104 individuals. 

Participants received conventional phacoemulsification surgery or femtosecond laser-assisted cataract surgery. Those with corneal astigmatism greater than 0.9 diopter (D) were offered LRIs (n=51) or femtosecond laser arcuate keratotomy (n=53). Investigators looked at visual acuity, postoperative refraction, and corneal topography 4 weeks postoperatively. Among the results: 

  • Average target induced astigmatism in the LRI groups was 1.50 D, vs 1.38 D in the femtosecond acute keratotomy contingent. 
  • Surgically induced astigmatism was 1.02 D and 1.23 D, respectively, which led to the femtosecond arcuate keratotomy group having a smaller difference vector (1.17 vs 0.89 D) and a greater correction index (0.48 versus 0.73).
  • 44% of femtosecond arcuate keratotomy group patients attained postop cylinder <0.50D, vs 20% in those in the LRI group.

Roberts H Wagh V, Sullivan D, Archer T, O’Brat D. Refractive outcomes after limbal relaxing incisions or femtosecond laser arcuate keratotomy to manage corneal astigmatism at the time of cataract surgery. J Cataract Refract Surg. 2018;44(8):955-963 . doi: https://doi.org/10.1016/j.jcrs.2018.05.027

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