Comparison of surgically induced astigmatism between femtosecond laser and manual clear corneal incisions for cataract surgery

J Cataract Refract Surg. 2015 Oct;41(10):2075-80. doi: 10.1016/j.jcrs.2015.11.004.

Abstract

Purpose: To assess the surgically induced corneal astigmatism (SIA) introduced by femtosecond laser-assisted clear corneal incisions (CCIs) for cataract extraction and to compare it with the SIA of manually created CCIs.

Setting: Bascom Palmer Eye Institute, Miller School of Medicine, Miami, Florida, USA.

Design: Prospective nonrandomized comparative case series.

Methods: Eyes received femtosecond laser-assisted CCIs (Group 1) or manual CCIs (Group 2). The surgical plan included 1 primary and 1 secondary port; the sites of the incisions were the same in both groups and were diametrically opposed between the right eye and left eye. The SIA was assessed using the preoperative and 1-month postoperative keratometric values obtained from corneal topography examinations.

Results: This study included 72 eyes of 68 patients with a mean age of 69.0 years ± 9.87 (SD) (range 36 to 90 years). Thirty-six eyes received femtosecond laser-assisted CCIs (Group 1) and 36 received manual CCIs (Group 2). The mean preoperative topographic corneal astigmatism was -1.19 ± 0.68 diopters (D) (range 0 to 2.50 D) and -0.92 ± 0.63 D (range 0.10 to 2.45 D) for Group 1 and Group 2, respectively, whereas, 1 month after cataract surgery, it was -1.16 ± 0.63 D (range 0.20 to 2.57 D) and -0.95 ± 0.64 D (range 0.21 to 2.37 D), respectively. Multivariate vector analysis revealed no statistically significant difference between the 2 groups for preoperative astigmatism, postoperative astigmatism, and SIA (P > .05 for all comparisons between Group 1 and Group 2).

Conclusion: Femtosecond laser-assisted and manual corneal incisions for cataract surgery did not appear to significantly alter corneal astigmatism, whereas they showed comparable SIA.

Financial disclosure: Drs. Yoo and Donaldson are speakers for and consultants to Alcon Surgical, Inc., and Abbott Medical Optics, Inc. No other author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Astigmatism / diagnosis
  • Astigmatism / etiology*
  • Astigmatism / physiopathology
  • Cornea / physiopathology
  • Cornea / surgery*
  • Corneal Topography
  • Female
  • Humans
  • Intraoperative Complications*
  • Male
  • Middle Aged
  • Phacoemulsification / adverse effects*
  • Prospective Studies
  • Refractive Surgical Procedures / adverse effects*
  • Visual Acuity / physiology