Femtosecond Laser-Assisted Astigmatic Keratotomy for Postoperative Trabeculectomy-Induced Corneal Astigmatism

PURPOSE:To describe a case of postoperative trabeculectomy-induced corneal astigmatism treated with femtosecond laser-assisted astigmatic keratotomy.METHODS:After trabeculectomy, the patient demonstrated change in manifest refraction from −0.5 diopters preoperatively to mixed astigmatism of −3.5 + 5.25@100 postoperatively and a decrease in uncorrected distance visual acuity from 20/60 preoperatively to 20/200 at 1 month postoperatively. Because the patient was intolerant to spectacle use, she underwent femtosecond laser-assisted astigmatic keratotomy.RESULTS:After astigmatic keratotomy there was improvement in corneal topographic astigmatism from 4.15 to 0.81 diopters with uncorrected distance visual acuity of 20/60After astigmatic keratotomy there was improvement in corneal topographic astigmatism from 4.15 to 0.81 diopters with uncorrected distance visual acuity of 20/60−2and manifest refraction of −0.75 + 1.0@90 at 3 months postoperatively. There were no intraoperative or postoperative complications.CONCLUSIONS:Femtosecond laser-assisted astigmatic keratotomy may be considered in eyes with postoperative trabeculectomy-induced mixed astigmatism.[[J Refract Surg.2014;30(7):502–504.]