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  • Title: Arcuate keratotomy for high postoperative keratoplasty astigmatism performed with the intralase femtosecond laser.
    Author: Buzzonetti L, Petrocelli G, Laborante A, Mazzilli E, Gaspari M, Valente P.
    Journal: J Refract Surg; 2009 Aug; 25(8):709-14. PubMed ID: 19714795.
    Abstract:
    PURPOSE: To evaluate the refractive and keratometric effect of arcuate keratotomy performed using the IntraLase femtosecond laser (Abbott Medical Optics) in patients with high postoperative keratoplasty astigmatism. METHODS: Nine eyes of nine patients (mean age 45 +/- 7.5 years; mean spherical equivalent refraction -2.50 +/- 3.60 diopters [D]) who had undergone a penetrating keratoplasty were considered. The subjective refraction was measured, and corneal thickness and keratometric parameters were calculated by the Pentacam (Oculus Optikgeräte). All uncomplicated surgeries were performed with the IntraLase femtosecond laser. Paired 70 degrees arc length incisions were performed at 80% depth of the corneal thickness. The mean optical zone was 5.9 mm. The side cut was 90 degrees. All incisions were performed in the graft itself. Mean change in best spectacle-corrected visual acuity (BSCVA), refractive and keratometric astigmatism, and spherical equivalent refraction was evaluated. Follow-up was 3 months. Refractive and keratometric data were analyzed using vector analysis as described by Alpins. A paired Student t test was used to compare preoperative and 3-month postoperative data. A P value <.05 was considered significant. RESULTS: Mean preoperative BSCVA was 20/30, increasing to 20/25 postoperatively (P > .05). The mean refractive astigmatism decreased by 6.00 D (P < .05), whereas the mean keratometric value decreased by 4.60 D (P < .05). The mean spherical equivalent refraction did not change significantly. The surgical vectors in the refractive and keratometric analysis were calculated, showing good predictability. CONCLUSIONS: Arcuate keratotomy performed with the IntraLase femtosecond laser could be an effective, safe, and relatively predictable treatment of high postoperative keratoplasty astigmatism.
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