Document Detail


IntraLase-enabled astigmatic keratotomy for post-keratoplasty astigmatism: on-axis vector analysis.
MedLine Citation:
PMID:  20163860     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the refractive predictability, stability, efficacy, and complication rate of femtosecond laser-enabled astigmatic keratotomy for post-keratoplasty astigmatism. DESIGN: A retrospective case series (pilot study). PARTICIPANTS: Thirty-seven eyes of 34 patients. METHODS: All eyes underwent IntraLase-enabled astigmatic keratotomy for high astigmatism (>5 diopters [D]) after penetrating keratoplasty. MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), manifest refraction, higher-order aberrations, and complications. RESULTS: Mean follow-up was for 7.2 months. Uncorrected visual acuity improved from a mean of 1.08+/-0.34 logarithm of the minimum angle of resolution preoperatively to a mean of 0.80+/-0.42 postoperatively (P=0.0016). Best-corrected visual acuity improved from a mean of 0.45+/-0.27 preoperatively to 0.37+/-0.27 postoperatively (P=0.018). The defocus equivalent was significantly reduced by more than 1 D (P=0.025). The value of absolute astigmatism was reduced from 7.46+/-2.70 D preoperatively to 4.77+/-3.29 D postoperatively (P=0.0001). Higher-order aberrations were significantly increased. The efficacy index was 0.6+/-0.6. There were no cases of perforation, wound dehiscence, or infectious keratitis. Three eyes (8%) experienced an episode of graft rejection. Overcorrection occurred in 9 eyes (24%). CONCLUSIONS: IntraLase-enabled astigmatic keratotomy is an effective treatment for high astigmatism after penetrating keratoplasty with an encouraging refractive predictability. Future studies may help refine the treatment parameters required to achieve reduction of cylinder with greater accuracy.
Authors:
Nikhil L Kumar; Igor Kaiserman; Raneen Shehadeh-Mashor; Wiwan Sansanayudh; Rusty Ritenour; David S Rootman
Publication Detail:
Type:  Journal Article     Date:  2010-02-16
Journal Detail:
Title:  Ophthalmology     Volume:  117     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-04     Completed Date:  2010-06-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1228-1235.e1     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, University of Toronto, Ontario, Canada. nik_kumar1@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Astigmatism / etiology,  physiopathology,  surgery*
Cornea / physiopathology,  surgery*
Corneal Topography
Female
Humans
Keratoplasty, Penetrating*
Lasers, Excimer / therapeutic use*
Male
Middle Aged
Postoperative Complications*
Refraction, Ocular / physiology
Retrospective Studies
Visual Acuity / physiology
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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