Journal Article

Short-Term Outcomes Using a Novel Femtosecond Laser-Assisted Keratotomy Nomogram to Manage Corneal Astigmatism During Phacoemulsification

Sun, Ashley, Longenecker, Amy, Mishra, Gautam, Lehman, Erik, Truong, Nguyen, Ernst, Brett, Seeger, Catherine, Pantanelli, Seth

2025

Overview

To evaluate the efficacy of a femtosecond laser assisted astigmatic keratotomy (AK) nomogram (FemtoAK.com) for correction of astigmatism during cataract surgery. Consecutive patients underwent cataract extraction with AKs and insertion of a non-toric intraocular lens. Eyes with greater than 0.5 D of against-the-rule (ATR) or 1.0 D of with-the-rule (WTR) or oblique (OBL) astigmatism were treated in accordance with the nomogram. Optical biometry and manifest refraction were checked pre- and one-month post-operatively. Outcome measures included correction index (CI), index of success (IOS), and proportion of eyes with less than 0.5 and 1.0 D of astigmatism. Ninety-five eyes from 69 patients were included, of which 41 had ATR, 35 had WTR, and 19 had OBL astigmatism. Corneal CI (ATR = 0.86, WTR = 0.27) indicated a small and large under-correction of ATR and WTR astigmatism, respectively, while refractive CI revealed a near-ideal correction of WTR (ATR = 0.87, WTR = 1.02). The proportion of eyes with less than 0.5 and 1.0 D of refractive astigmatism increased from 28% and 54% pre-operatively to 56% and 92% post-operatively, respectively. The FemtoAK nomogram is effective at reducing corneal astigmatism at the time of cataract surgery. Astigmatic correction was more precise when evaluated by refractive rather than corneal measures.

• Publisher: Dove Medical Press Limited,Taylor & Francis Ltd,Dove,Dove Medical Press
• Subject: arcuate incisions / Astigmatism / Biometrics / Cataract / Cataracts / Contact lenses / Cornea / Enrollments / Eye surgery / femtoak / femtosecond laser / keratotomy / Lasers / Nomograms / Original Research / Pandemics / Patients / Surgeons / Surgery / Surgical outcomes / Topography