Correcting Corneal Astigmatism with Corneal Arcuate Incisions during Femtosecond Laser Assisted Cataract Surgery

Nguyen Xuan  Hiep; Pham Thi Minh  Khanh; Do  Quyet; Than Van  Thai; Vu Thi  Nga; Toi  Chu Dinh; Nguyen Duy Bac

doi:10.3889/oamjms.2019.371

Authors

Nguyen Xuan Hiep Vietnam National Institute of Ophthalmology, Hanoi, Vietnam
Pham Thi Minh Khanh Vietnam National Institute of Ophthalmology, Hanoi, Vietnam
Do Quyet Vietnam Military Medical University (VMMU), Hanoi, Vietnam
Than Van Thai NTT Hi-tech Institute, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
Vu Thi Nga Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Vietnam
Toi Chu Dinh Department of Human and Animal Physiology, Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
Nguyen Duy Bac Vietnam Military Medical University (VMMU), Hanoi, Vietnam

DOI:

https://doi.org/10.3889/oamjms.2019.371

Keywords:

Femtosecond laser, Corneal astigmatism, Arcuate incision

Abstract

BACKGROUND: Astigmatic management is an important step to achieve the best visual quality after refractive cataract surgery. Nowadays, along with progress in cataract surgery, the femtosecond laser can produce the arcuate incisions high precisely that help the astigmatic correction. In Vietnam, it has not yet any study about this issue, so we perform this study.

AIM: To assess the efficacy and safety of arcuate corneal incisions in treatment corneal astigmatism during femtosecond laser-assisted cataract surgery.

METHODS: In this clinical interventional study, forty-five cases with cataract and corneal astigmatism (> 0.50D) were treated with corneal arcuate incisions and femtosecond-laser assisted cataract surgery in Vietnam National Institute of Ophthalmology, from January 2017 to May 2018. The uncorrected and corrected distance visual acuity, refraction spherical equivalent, corneal astigmatism were measured (using an OPD-Scan III topographer) before, 1 week and 3 months after surgery. Some features of arcuate corneal incisions (quantity, depth, length and morphology), spectacle independence at a distance and complications were recorded.

RESULTS: The rate of postoperative spherical refraction equivalent was within Â± 0.50D and Â± 1.0D at 3 months (in 95.6% and 100% of the eyes respectively). Mean length of arcuate corneal incisions was 53.78o Â± 17.683o (range: 20o to 85o). The average of preoperative corneal astigmatism was 1.65 Â± 0.83D, decreased to 0.59 Â± 0.549D in the third month after surgery. Surgical induced astigmatism was 1.05 Â± 0.449D and lower than preoperative corneal astigmatism (1.65 Â± 0.83D), thereby this indicated undercorrection. However, the rate of spectacle independence was 82.3%, and no complications were recorded.

CONCLUSION: Correcting of corneal astigmatism in femtosecond laser-assisted cataract surgery combined with the formation of the arcuate incisions is a new and modern method for high safety and efficacy.