A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery

Connor J Baharozian,1 Christian Song,2,3 Kathryn M Hatch,2,3 Jonathan H Talamo2,3 1Boston University School of Medicine, 2Massachusetts Eye and Ear Infirmary, 3Department of Ophthalmology, Harvard Medical School, Boston, MA, USA Purpose: The purpose of this study was to determine an arcuate incisi...

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Autores principales:	Baharozian CJ, Song C, Hatch KM, Talamo JH
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	femtosecond laser cataract surgery astigmatism keratotomy nomogram limbal relaxing incisions Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/2f2274cab08c4208a00ff65c585e5f2f
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spelling	oai:doaj.org-article:2f2274cab08c4208a00ff65c585e5f2f2021-12-02T02:36:18ZA novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery1177-5483https://doaj.org/article/2f2274cab08c4208a00ff65c585e5f2f2017-10-01T00:00:00Zhttps://www.dovepress.com/a-novel-nomogram-for-the-treatment-of-astigmatism-with-femtosecond-las-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Connor J Baharozian,1 Christian Song,2,3 Kathryn M Hatch,2,3 Jonathan H Talamo2,3 1Boston University School of Medicine, 2Massachusetts Eye and Ear Infirmary, 3Department of Ophthalmology, Harvard Medical School, Boston, MA, USA Purpose: The purpose of this study was to determine an arcuate incision (AI) nomogram to treat astigmatism during femtosecond laser-assisted cataract surgery. Methods: This is a retrospective, cohort study. Femtosecond laser (FSL)-assisted transepithelial AIs were created at a 9.0 mm optical zone, 80% depth, centered on the limbus. We modified the manual Donnenfeld limbal relaxing incision nomogram to 70% for with-the-rule (WTR), 80% for oblique (OBL), and 100% for against-the-rule (ATR) astigmatism. The correction index (CI) equaled AI-induced astigmatism/target-induced astigmatism. Measures included preoperative keratometric corneal cylinder (Pre Kcyl), postoperative Kcyl (Post Kcyl), and postoperative residual refractive astigmatism (Post RRA). Results: Mean Pre Kcyl and 1–2 months Post RRA in 161 eyes of 116 patients were 0.626±0.417 diopters (D) (range 0.5–2 D), and 0.495±0.400 D (range 0–1.5 D), respectively. Mean absolute astigmatic changes (Pre Kcyl–Post Kcyl) without accounting for axis change in the WTR, ATR, and OBL groups were 0.165±0.383 D (P<0.001), 0.374±0.536 D (P<0.001), and 0.253±0.416 D (P=0.02), respectively. Mean absolute astigmatic changes using RRA as the postoperative measurement (Pre Kcyl–Post RRA) without accounting for axis change were 0.440±0.461 D (P<0.001), 0.238±0.571 D (P<0.05), 0.154±0.450 (P=0.111) in WTR, ATR, and OBL groups, respectively. CIs for WTR, ATR, and OBL were 0.53, 1.01, and 0.95, respectively. There were no intraoperative or postoperative complications related to the AIs.Conclusion: Transepithelial FSL-AIs using the modified Donnenfeld nomogram show potential for management of mild to moderate corneal astigmatism. An increase in the magnitude or reduction of the optical zone size for the treatment of WTR and ATR astigmatism for this nomogram may further improve refractive accuracy. Keywords: femtosecond laser, cataract surgery, astigmatism, keratotomy, nomogram, limbal relaxing incisionsBaharozian CJSong CHatch KMTalamo JHDove Medical Pressarticlefemtosecond lasercataract surgeryastigmatismkeratotomynomogramlimbal relaxing incisionsOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 1841-1848 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	femtosecond laser cataract surgery astigmatism keratotomy nomogram limbal relaxing incisions Ophthalmology RE1-994
spellingShingle	femtosecond laser cataract surgery astigmatism keratotomy nomogram limbal relaxing incisions Ophthalmology RE1-994 Baharozian CJ Song C Hatch KM Talamo JH A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery
description	Connor J Baharozian,1 Christian Song,2,3 Kathryn M Hatch,2,3 Jonathan H Talamo2,3 1Boston University School of Medicine, 2Massachusetts Eye and Ear Infirmary, 3Department of Ophthalmology, Harvard Medical School, Boston, MA, USA Purpose: The purpose of this study was to determine an arcuate incision (AI) nomogram to treat astigmatism during femtosecond laser-assisted cataract surgery. Methods: This is a retrospective, cohort study. Femtosecond laser (FSL)-assisted transepithelial AIs were created at a 9.0 mm optical zone, 80% depth, centered on the limbus. We modified the manual Donnenfeld limbal relaxing incision nomogram to 70% for with-the-rule (WTR), 80% for oblique (OBL), and 100% for against-the-rule (ATR) astigmatism. The correction index (CI) equaled AI-induced astigmatism/target-induced astigmatism. Measures included preoperative keratometric corneal cylinder (Pre Kcyl), postoperative Kcyl (Post Kcyl), and postoperative residual refractive astigmatism (Post RRA). Results: Mean Pre Kcyl and 1–2 months Post RRA in 161 eyes of 116 patients were 0.626±0.417 diopters (D) (range 0.5–2 D), and 0.495±0.400 D (range 0–1.5 D), respectively. Mean absolute astigmatic changes (Pre Kcyl–Post Kcyl) without accounting for axis change in the WTR, ATR, and OBL groups were 0.165±0.383 D (P<0.001), 0.374±0.536 D (P<0.001), and 0.253±0.416 D (P=0.02), respectively. Mean absolute astigmatic changes using RRA as the postoperative measurement (Pre Kcyl–Post RRA) without accounting for axis change were 0.440±0.461 D (P<0.001), 0.238±0.571 D (P<0.05), 0.154±0.450 (P=0.111) in WTR, ATR, and OBL groups, respectively. CIs for WTR, ATR, and OBL were 0.53, 1.01, and 0.95, respectively. There were no intraoperative or postoperative complications related to the AIs.Conclusion: Transepithelial FSL-AIs using the modified Donnenfeld nomogram show potential for management of mild to moderate corneal astigmatism. An increase in the magnitude or reduction of the optical zone size for the treatment of WTR and ATR astigmatism for this nomogram may further improve refractive accuracy. Keywords: femtosecond laser, cataract surgery, astigmatism, keratotomy, nomogram, limbal relaxing incisions
format	article
author	Baharozian CJ Song C Hatch KM Talamo JH
author_facet	Baharozian CJ Song C Hatch KM Talamo JH
author_sort	Baharozian CJ
title	A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery
title_short	A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery
title_full	A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery
title_fullStr	A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery
title_full_unstemmed	A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery
title_sort	novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/2f2274cab08c4208a00ff65c585e5f2f
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A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery

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