Long-term Results of Arcuate Keratotomy in Femtosecond Laser-assisted Cataract Surgery

Purpose: To investigate the long-term follow-up results of arcuate keratotomy in femtosecond laser-assisted cataract surgery. Methods: The medical records of 78 patients (99 eyes) with corneal astigmatism >0.5 diopters (D) who underwent arcuate keratotomy concurrent with femtosecond laser-assisted cataract surgery were retrospectively reviewed. Uncorrected and corrected visual acuities and keratometric and higher order aberration outcomes were compared preoperatively and 2 years postoperatively. Results: The mean uncorrected visual acuities and corrected visual acuities changed from 0.55 +/- 0.31 D and 0.33 +/- 0.26 D, preoperatively to 0.13 +/- 0.19 D and 0.07 +/- 0.09 D, 2 years postoperatively. The mean preoperative corneal astigmatism was -1.15 +/- 0.66 D. This was reduced to -0.79 +/- 0.38 D at 1-2 days after surgery (p < 0.001), followed by no significant change for 2 years. The mean target-induced astigmatism was 1.15 +/- 0.66 D preoperatively, and the mean surgically-induced astigmatism and difference vector were 0.69 +/- 0.43 D and 0.83 +/- 0.48 D, 2 years postoperatively. The mean correction index was 0.68 +/- 0.45, 2 years postoperatively. There was no significant difference in higher order aberrations except 4 mm and 6 mm total higher order aberrations and 6 mm trefoil between preoperatively and 2 years postoperatively. Conclusions: Arcuate keratotomy concurrent with femtosecond laser-assisted cataract surgery is a safe and effective way to reduce corneal astigmatism which remained stable over 2 years of follow-up with below moderate astigmatism.