Femtosecond laser shows promise in astigmatism correction

Arcurate keratotomy performed with a femtosecond laser  at the time of cataract surgery can produce results similar to those achieved with toric IOLs and the accuracy of the technique is likely to improve as experience with the new technology increases, said Roberto Bellucci MD, Italy, at the 19th ESCRS Winter Meeting in Istanbul.

He presented the results of a study in which 23 eyes of 16 cataract patients with a mean age 69 years who underwent the femtosecond laser procedure to correct 1.5 D to 5.5 D of corneal astigmatism.

Dr Bellucci performed the arcuate corneal incisions at the time of surgery prior to performing the incisions to open the anterior chamber and removing the cataract.In all eyes he used the Victus femtosecond laser and calculated the length of the incisions on the Bascom Palmer algorithm.

At six months follow-up, the patients had a mean of 0.7 D of astigmatism, compared to 2.0 D preoperatively. The axis of astigmatism had shifted by a mean of 10.5 degrees.

Dr Bellucci noted that precision with the technique will improve with the introduction of new nomograms designed specifically for incisions created with the femtosecond laser. Other developments that will improve outcomes include curved interfaces for the lasers which will cause less applanation, the incorporation of accurate posterior cornea measurements, and incisions guided intraoperatively with OCT. In addition, the safety and stability of the incisions may be improved by performing them intrastromally.