Our Experience With Femtosecond Laser-Assisted Cataract Surgery: Management Of The Astigmatism Performing Arcuate Incisions.

To treat patients with cataract with femto-assisted phacoemulsification surgery in order to obtain a more precise and reproducible surgical result than the traditional cataract surgery. We also investigated the effectiveness of femtosecond laser arcuate incisions in correcting corneal astigmatism.

We treated 673 patients with cataract with femtosecond laser-assisted cataract surgery. Patient inclusion criteria were: cataract, mydriasis >6.2 mm, healthy cornea. Of the 673 patients, 43 cases with pre-operative topographic astigmatism between 0.75 and 3.5 diopters were selected and treated with corneal arcuate incisions. Patients were divided in group A with corneal astigmatism range from 0.75 to 2.0 and group B above 2.0. Corneal topography was performed before surgery, 1 month after surgery, and 3 months after surgery. The arcuate incisions were calculated with the Donnenfeld normogram.

In 658 cases the femto-assisted procedure was successfully completed. Loss of vacuum occurred in 14 patients after femto-assisted capsulotomy. Only 1 case of femto-assisted capsulotomy was interrupted and completed manually. No patients experienced intra or postoperative complications. The total average of preoperative corneal astigmatism was 1.44±0.76D decreased to 0.92±0.70D in the 3rd month after surgery. Preoperative astigmatism in group A was 1,18±0,42D, at 3 months after surgery was 0,8±0,72D. Preoperative astigmatism in group B was 2,56±1,6D, at 3 months after surgery was 1,18±0.48D. 

Our data showed a reduction of topographic astigmatism after treatment with arcuate incisions. The effect of  arcuate incisions is greater in astigmatism >2D. Our goal is to increase case studies (creating a control group) in order to learning better the surgical procedure and improve our results.