Long-Term Stability of Femtosecond Astigmatic Keratotomy After Treatment of High Postkeratoplasty Astigmatism.

Purpose: The purpose of this study was to assess long-term stability and outcomes of femtosecond astigmatic keratotomy (FSAK) after treatment of high postkeratoplasty astigmatism.
Methods: This retrospective study included patients who underwent FSAK for high astigmatism (≥4 D) after penetrating keratoplasty or deep anterior lamellar keratoplasty. Main outcome measures were corneal astigmatism, uncorrected visual acuity, and best-corrected visual acuity (BCVA) at 1 month and 1, 5, and 10 years.
Results: Overall, 61 eyes of 61 patients (mean age 56 ± 19 years, 54.1% male) were included in this study. Preoperative corneal astigmatism ranged from 4 to 25 D. One month after FSAK, mean corneal astigmatism was significantly reduced from 9.02 ± 3.97 D to 4.86 ± 3.10 D ( P < 0.001). Thereafter, corneal astigmatism remained stable at all visits up to 10 years ( P < 0.05 for all compared with baseline). After FSAK, there was a significant improvement in logMAR uncorrected visual acuity from 1.21 ± 0.48 to 0.87 ±0.54 ( P < 0.001) and logMAR BCVA from 1.03 ± 0.55 to 0.49 ± 0.45 ( P < 0.001) which remained stable up to 10 years. A mild reduction in BCVA improvement was seen between 1 month and 1 year.
Conclusions: Femtosecond astigmatic keratotomy was effective and stable at reducing very high magnitudes of postkeratoplasty astigmatism over the long term. The procedure also had a stable effect on visual acuity, albeit some reduction in the degree of BCVA improvement was seen over the early postoperative period.
Competing Interests: A. R. Slomovic: consultant for Alcon, Bausch & Lomb, Santen, and Abvie; advisory board member at Allergan and Shire; received research funding from AMO. D. S. Rootman: consultant for Alcon; received research funding from Johnson & Johnson. C. C. Chan: received personal fees for lectures, honoraria, and consulting from Santen, Johnson & Johnson, Allergan, Alcon, Bausch & Lomb, Zeiss, Novartis, TearLab, Sun Pharma, Aequus, Daichii, and Labtician Thea; received research funding from Novartis, Allergan, Bausch & Lomb, and Tear Laboratory. M. Mimouni: consultant for Eye Yon Medical and Lapidot Medical. N. Sorkin: received advisory board honoraria from Beyeonics Vision. The remaining authors have no conflicts of interest to disclose.
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